Anti kickback statute Study guides, Class notes & Summaries

NCCT REVIEW LAW AND ETHICS EXAM QUESTIONS AND ANSWERS 1. Which of the following activities is an example of abuse rather than fraud? A. upcoding B. misrepresenting the diagnosis C. inadvertent coding errors D. billing for services not rendered - Answer-inadvertent coding errors Rationale Abuse is an unintentional mistake. Fraud is an intentional misrepresentation for gain. Upcoding, misrepresenting the diagnosis, and billing for services not rendered are examples of fraud. Inadvertent ...

AAPC CPB Chapter 1-5 Complete Questions With Answers 2024. Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination of benefits d. Physician unique identifier number - correct answer d. Physician unique identifier number A physician received office space at a reduced rate for referring patients to the hosp...

CPMA Exam Questions and Answers Latest Updated 2023 CMS Fraud Definition Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Abuse Definition An action that results in unnecessary costs to a federal healthcare program, either directly or indirectly CMS Examples of Fraud Billing for services and/or supplies that you know were not furnished or provided, altering claim forms and/or receipts to receive a ...

AABB correct answers American Association of Blood Banks; one of six CMS- approved accreditation organizations Abuse correct answers Improperly, and often unknowingly, violating regulations ALJ hearing correct answers The third level of Medicare appeal; the amount in controversy threshold for 2012 is $130 American Association of Blood Banks correct answers AABB; one of six CMS - approved accreditation organizations. American Osteopathic Association correct answers AOA; one of six CMS...

5 most important federal fraud and abuse laws: correct answers*False Claims Act (FCA) *Anti - kickback Statute (AKS) *Physician Self-Referral Law (Stark I II III ) *Exclusion Authorities *Civil Monetary Penalties Law (CMPL) The purpose of EMTALA is to prevent: a. Hospitals from rejecting patients in a discriminatory manner by, refusing treatment, or transferring patients to "charity hospitals" or "county hospitals," because they are unable to pay. b. Hospitals from admitting patient...

AABB - ANSWER American Association of Blood Banks; one of six CMS- approved accreditation organizations Abuse - ANSWER Improperly, and often unknowingly, violating regulations ALJ hearing - ANSWER The third level of Medicare appeal; the amount in controversy threshold for 2012 is $130 American Association of Blood Banks - ANSWER AABB; one of six CMS - approved accreditation organizations. American Osteopathic Association - ANSWER AOA; one of six CMS - approved accreditation organizat...

Center for Medicare and Medicaid Services (CMS) CORRECT ANSWER The Centers for Medicare & Medicaid Services, is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program, and health insurance portability standards. Waste CORRECT ANSWER Incurring unnecessary costs as a result of deficient management, practices, or control...

CHAA Study Guide Latest Version Graded A Accreditation Defined as "a self-assessment and external peer assessment process used by healthcare organizations to accurately assess their level of performance in relation to established standards and to implement ways to continuously improve." Examples include: TJC, Healthcare Accreditation Program, DNVGL helps organize patient safety efforts, improves risk management, provides education, provides professional advice, authority for Med...

AAPC CPB Chapter 1-5Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination of benefits d. Physician unique identifier number - correct answer d. Physician unique identifier number A physician received office space at a reduced rate for referring patients to the hospital's out- patient physical therapy ce...

AABB correct answer: American Association of Blood Banks; one of six CMS- approved accreditation organizations Abuse correct answer: Improperly, and often unknowingly, violating regulations ALJ hearing correct answer: The third level of Medicare appeal; the amount in controversy threshold for 2012 is $130 American Association of Blood Banks correct answer: AABB; one of six CMS - approved accreditation organizations. American Osteopathic Association correct answer: AOA; one of si...