Cpma 2024 Latest Update Correct Questions & Answers!

When non-compliance is identified, what does the OIG recommended? a .Take disciplinary action and document the date of the incident, name of the reporting party, name of the person responsible for taking action, and the follow-up action taken. b. Take disciplinary action and document the date of the incident, name of the reporting party, name of the person responsible for taking action,and the follow-up action taken. c. Immediately terminate employment for the party found in non-compliance,regardless of the severity of the offense,document the date of the termination,file a corrected claim on all claims affected. d. Continue to watch the employee in non-compliance until the incidents meet a federal level before taking action. - ANSWER b. Take disciplinary action and document the date of the incident, name of the reporting party, name of the person responsible for taking action,and the follow-up action taken A provider consistently charges a higher level E/M service than is documented to help cover the cost of his declining practice. Would this be fraud or abuse Why? a. Abuse,charging one level higher on each visits does not show intent. b. Abuse; the provider's practice is common and therefore would not be considered fraudulent . c. Fraud; and over-coding of services would be considered fraudulent. d. Fraud; the provider intentionally over-coded to gain financially. - ANSWER d. Fraud; the provider intentionally over-coded to gain financially. The OIG lists potential risk areas for individual and small physician groups in the compliance plan guidance. Which option below is listed as a risk area? a. Unbundling b. Under Coding c. Overuse of E/M codes d. Failure to follow the "same day" rule - ANSWER a. Unbundling