CDEO Chapter 3 Exam With Verified Answers

CDEO Chapter 3 Exam With Verified Answers Documentation states that the patient had a "Status post hysterectomy. The patient presents with a fever." Which of the following would be a compliant question to query? -Correct Answer-Do you know the cause of the fever? Operation Restore Trust -Correct Answer-3 offices were involved: OIG, Healthcare Financing Administration, AoA May 1995 Bill Clinton: 2 yr partnership of federal and state agencies, working together to protect the healthcare trust funds through shared intelligence coordinated enforcement, intended to enhance quality of care for program's beneficiaries. Program is not called Senior Medicare Patrol SMP They work to combat fraud and abuse. SMP -Correct Answer-Senior Medicare Patrol OIG -Correct Answer-Office of Inspector General AoA -Correct Answer-Administration on Aging FCA -Correct Answer-False Claims Act CMPL -Correct Answer-Civil Money Penalties Law CMS Definition of Fraud -Correct Answer-knowingly making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Definition of Abuse -Correct Answer-an action resulting in unnecessary costs to a federal healthcare program either directly or indirectly CMS Examples of Fraud -Correct Answer-Billing for Services/Supplies that you know were not furnished or provided Altering claim forms and/or receipts to receive a higher payment amount Billing for services at a level higher than provided or necessary Misrepresenting the diagnosis to justify payment