Study guides, Class notes & Summaries

HCCA CHC Exam Prep | 750+ Questions and Verified Answers| 2023/ 2024 Q: True of False: A self-audit is an examination or inspection for providers in reducing non-compliance. Self-audits can lower chances of an external audit and create a robust culture of compliance Answer: True Source: CHC Exam Secrets Study Guide Q: CMS released areas of high-risk fraud, some of those include: A. Sudden changes in billing and billing inappropriate specialties B. Billing of inappropriate d...

CHC Practice Exam Questions and Correct Answers 2024

CHC Practice Exam Questions and Correct Answers 2024

"Incident To" services - services commonly furnished in a physician's office by a nurse practitioner in which there is direct physician personal supervision and are billed under the physician's provider number (does not apply in hospital setting) physician must be present to bill (*) 1500 Form - Non-institutional providers must use this form to bill Medicare, Medicaid, CHAMPUS, and most private insurance companies used to bill Part B claims 72 Hour Rule/3 Day Window Project (*) - all ...

A behavioral health specialist notices a particularly high number of restraint deaths at a facility. An analysis of the root causes of these events is most likely to indicate problems with: a. Equipment b. Staff orientation and training c. Staffing levels d. Alarm systems - b. Staff orientation and training Equipment, staffing levels, and alarm system can also be culpable in restraint deaths, but problems with orientation and training are much more likely. A healthcare facility's income...

_____ refers to the max output current under any non capacitive load with overcurrent protection skipped. a) Amax b) RAmax c) ZAmax d) VAmax e) Imax - e) Imax _______ wireways are preferred when there is a need to, within the raceway, make terminations, splices, or taps to several devices. a) metal b) plastic c) PVC - a) metal ________ has a valve that can automatically close upon the deactivation of its opening means. a) self-closing faucet b) relief vent c) self-closing water se...

A billing manager is reviewing the monthly reimbursement report for the department. The manager notices that there is an increase of 50% over the expected amount of incoming payments from Federal health care programs for treatment of patients. The manager believes action is needed. The manager's NEXT step is to: 1. Stop all outgoing claims to Federal health care programs 2. Extrapolate the last 6 months of reimbursement totals to identify the overpayment due to health care programs 3. Co...

"ERISA" - Employment Retirement Income Security Act of 1974 5 most important federal fraud and abuse laws - *False Claims Act (FCA) *Ant - kickback Statute (AKS) *Physician Self-referral *Law (Stark I II III ) *Exclusion Authorities *Civil Monetary Penalties Law (CMPL) AKS - FCA relationship - The Patient Protection and Affordable Care Act of 2010 expanded the liability of the False Claims Act to now definitively include Anti-Kickback claims as grounds for violation. Prior to the healt...

CHC Practice Exam Questions and Correct Answers 2024

CHC Practice Exam Questions and Correct Answers 2024