solutions 2024/2025
Which is considered Medicare abuse? - ANSWER-Misusing codes on a claim
What is the most significant difference between 1996 and 1997 documentation
guidelines? - ANSWER-Examination
The goal of the Recovery Audit Contractor (RAC) program is to - ANSWER-
Identify improper payments made on claims of healthcare services provided to
Medicare beneficiaries
Submitting claims for expired drugs falls under which of the following - ANSWER-
False Claim Act (FCA)
The False Claims Act (FCA) allows for mitigation under what circumstances? -
ANSWER-The person committing the violation self-discloses and provides all
known information within 30 days, fully cooperates with the investigation, and
there is no criminal prosecution, civil action, or administrative action regarding
the violation.
In the National Correct Coding Initiative, files contain a Correct Coding Modifier
(CCM) indicator. What does CCM indicator 1 mean? - ANSWER-A CCM is allowed
and will bypass the edits
What document identifies the area that will be scrutinized by the federal
government I. The current and coming year? - ANSWER-HHS OIG Work Plan
In the Exclusion Statue a physician is banned from? - ANSWER-Participating in
any federal or state healthcare program by the OIG