RHIT Exam Compliance 2023- Solved

sub poenas - ANSWER-audit trails calling out patient's name - ANSWER-incidental disclosure- permitted minimum necessary sentinel event - ANSWER-infant abduction coding compliance - ANSWER-are codes supported by valid documentation Medicare Integrity Program - ANSWER-Payment determinations and audit of cost reports. Healthcare fraud and abuse. The focus expanded to cost reports, payment determinations, and the need for ongoing compliance education most common forms of fraud and abuse - ANSWER-billing for services not furnished; misrepresenting the diagnosis to justify payment; soliciting, offering, or receiving a kickback; unbundling; falsifying certificates of medical necessity; and billing for a service not furnished as billed, known as upcoding CDI program - ANSWER-retrospective record review and queries, with concurrent record review and queries, or with concurrent coding. policies and procedures section of a coding compliance plan should include - ANSWER-physician query process, coding diagnosis not supported by health documentation, upcoding, correct use of encoder software, unbundling, coding health records without complete documentation, assignment of discharge destination codes, and complete process for using scrubber software When the Medicare Recovery Audit Contractor has determined that incorrect payment has been made to an organization - ANSWER-Demand letter (denial letter) includes the providers identification, reason for the review, list of claims, reasons for any denials, and amount of the overpayment for each claim. investigational technique that facilitates the identification of the various factors that contribute to a problem? - ANSWER-cause-and-effect diagram is an investigational technique benefits of a coding compliance plan - ANSWER-Retention of high standard of coding drug diversion - ANSWER-employee keeps drugs for themselves