Fraud act Study guides, Revision notes & Summaries

Steps used to control costs of managed care include: - ANSWER-Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - ANSWER-Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage - ANSWER-HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a savings...

QUESTION 1: CIVIL PRACTICE [50] 1.1 Darren Smith is the director and shareholder of DSA Equipment (Pty) Ltd (“DSA”) and the company manufactures medica electronic equipment. Mr. Smith approached EBA (Pty) Ltd (“EBA”), the local supplier of the components needed for the manufacturing of the electronic equipment by DSA, and the parties entered into a written agreement for the supply and delivery of the components on 30-day credit terms. The goods are delivered by EBA to DSA’s premises an...

Michigan Residential Builder's License Test Bank|1190 Questions and Answers, 100% Correct| A+ Rated Solution Guide| Latest What is the 1st offense penalty for engaging in the practice of residential building without a license? Not less than $5K and not more than $25K and/or 1 year What is the penalty for engaging in the practice of residential building, resulting in a death? Not less than $5K and not more than $50K and/or 4 years On your individual builder's license application, what...

Which law requires the applicant be notified before a consumer report is ordered: - Fair Credit Reporting Act The Insuring Clause of an A&H policy usually states all of the following, EXCEPT: A. That insurance against loss is provided B. That a loss must result directly from stated accidents or sicknesses C. The method of premium payment D. The identities of the insurance company and the insured - C. The method of premium payment Which of the following statements about Medicare is/are tru...

FITSP-MANAGER EXAM QUESTIONS AND ANSWERS this legislation requires Federal agencies to develop document and implement an agency wide information security program - Answer ️️ -Clinger-Cohen What are the six steps of the RMF - Answer ️️ -Categorize Select Implement Assess Authorize Monitor What is the term used to evaluate operational information systems against the RMF, to determine the security controls in place and the requirements to mitigate risk at a acceptable level? - An...

UNITED HEALTHCARE (UHC) – ETHICS AND COMPLIANCE LATEST 2023-2024 EXAM| ACTUAL QUESTIONS AND VERIFIED ANSWERS Version 2 |A+ GRADE Q: John has Power of Attorney to act on behalf of his mother. What does that mean when it comes to his mother enrolling in a Medicare Advantage Plan? Answer: John may sign the Enrollment Application and must be able to provide documentation upon request by the Plan that indicates his authority under state law to enroll his mother. Q: In which of the...

HFL1501 PORTFOLIO MEMO - MAY/JUNE 2024 - SEMESTER 1 - UNISA - UNIQUE NUMBER:- 567217 - DUE 9 MAY 2024 - DETAILED ANSWERS WITH FOOTNOTES & BIBLIOGRAPHY- DISTINCTION GUARANTEED! QUESTION 1 1.1 Read the following statement and answer the question that follows: “South Africa has an uncodified legal system.” In your own words, discuss how this fact impacts on a lawyer who is searching for a remedy with regard to a legal question. (4) 1.2 Name one country of which you have learned in thi...

Bail Bonds Louisiana Exam With 100% Correct Answers 2023 Acquit - Correct Answer-to set free:to judicially discharge from an acquisition;to clear (a person) of a criminal charge Bail Enforcement - Correct Answer-the apprehension or surrender of a principal by a natural person who is released on bail or who has failed to appear at and state of the proceedings to answer to the charge before the court, in which he may be prosecuted obligor - Correct Answer-the party who owes the duty or debt...

True or False: The ACA requires that all providers adopt a compliance plan as a condition of enrollment with Medicare, Medicaid, and Children's Health Insurance Program (CHIP). - Answer- True ref. ACA section 6102 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) - Answer- 1.Protect our programs 2.Protect your patients 3.Protect the Provider At which level of the Medicare Part A or Part B appeals process is the app...

CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023 Steps used to control costs of managed care include: Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage HMO Conventional PPO and POS H...