Healthcare compliance Study guides, Class notes & Summaries

Healthcare Compliance, common laws and regulations questions and answers

5 most important federal fraud and abuse laws: correct answers *False Claims Act (FCA) *Anti - kickback Statute (AKS) *Physician Self-Referral Law (Stark I II III ) *Exclusion Authorities *Civil Monetary Penalties Law (CMPL) The purpose of EMTALA is to prevent: a. Hospitals from rejecting patients in a discriminatory manner by, refusing treatment, or transferring patients to "charity hospitals" or "county hospitals," because they are unable to pay. b. Hospitals from admitting patien...

CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023 Steps used to control costs of managed care include: Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage HMO Conventional PPO and POS H...

1/ A 5-week-old infant who developed projectile vomiting over the last two weeks is diagnosed with hypertrophic pyloric stenosis. Which intervention should the nurse plan to implement? A. Instruct the mother to give the child sugar water only. B. Offer the infant oral rehydration solution every 2 hours. C. Provide Pedialyte feedings via the nasogastric tube. D. Maintain intravenous fluid therapy per prescription. 2/ A client with myasthenia gravis (MG) is receiving immunosuppressive therap...

(WGU C807) HIM 3215 HEALTHCARE COMPLIANCE FINAL EXAM REVIEW Q & A 2024(WGU C807) HIM 3215 HEALTHCARE COMPLIANCE FINAL EXAM REVIEW Q & A 2024(WGU C807) HIM 3215 HEALTHCARE COMPLIANCE FINAL EXAM REVIEW Q & A 2024

AHIP TRAINING Medicare Fraud, Waste, and Abuse Training EXAM 50+ QUESTIONS AND VERIFIED CORRECT ANSWERS 2023. AHIP TRAINING Medicare Fraud, Waste, and Abuse Training 1. Medicare plan means: A MA plan, MA-PD plan or PDP 2. Subcontractor means: **An individual or entity that provides services on behalf of a Medicare plan sponsor. This includes individuals and organizations with DIRECT relationship with the plan sponsor or individuals or organizations with INDIRECT relationship, such as ...

Chc Certified Healthcare Compliance Exam Update Questions and Correct Answers Rated A+

HCCA – CHPC Health Care Compliance Association HCCA Certified in Healthcare Privacy Compliance Overview Updated 2023/ 2024 QUESTIONS AND VERIFIED CORRECT ANSWERS HIPAA became law --------- Correct Answer ------- 1996 What is the purpose of HIPAA? --------- Correct Answer ------- • To make health insurance portable under ERISA; • To move health care onto a nationally standardized electronic billing platform; and • To prevent fraud, waste and abuse Intent --------- Correct Answer ...

United Health Care Insurance Exam| Questions and Verified Answers| Grade A (2023/2024 New Update) QUESTION Do consumers have to be an AARP member to enroll in an AARP-branded plan with UnitedHealthcare? Answer: Yes, if the consumer is enrolling in a Medicare Supplement Plan QUESTION How many status levels are in the Authorized to Offer Program? Answer: 2 QUESTION According to AARP, there are how many individual AARP members? Answer: Nearly 37 milli...