Fraud waste and abuse Study guides, Class notes & Summaries

Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper Management only. - False Ways to report a compliance issue include: a. Telephone hotlines b. Report on the Sponsor's website c. In-person reporting to the compliance department/supervisor d. All of the above - d. All of the above What is the policy of non-retaliation? a. Allows the Sponsor to discipline employees who violate the Code of Conduct b. Prohibits management and supervisor from harassin...

UNITED HEALTHCARE (UHC) – ETHICS AND COMPLIANCE LATEST 2023-2024 EXAM| ACTUAL QUESTIONS AND VERIFIED ANSWERS |A+ GRADE Q: Agent Jacob learns that Emily, the consumer with whom he is meeting, is the authorized legal representative for her father. What must Jacob explain to Emily when completing an Enrollment Application for her father? Answer: Jacob must explain that Emily will sign the Enrollment Application and must be able to provide documentation upon request by the Plan that indic...

ACA Section 1557 differs from earlier legislation in providing broader protection against discrimination based on - sex Section 1557 of the Affordable Care Act applies to - c. all health programs and activities administered by or receiving federal financial assistance from HHS. Correct Which Medicare programs are covered by ACA Section 1557? - a. Parts A, C, and D, but not B. Correct Under ACA Section 1557, prohibited actions involve - d. eligibility, claims, and marketing. Correct Under...

HCCA - CHPC Study Guide - 296 Questions And Answers What is the purpose of HIPAA? - CORRECT ANSWERS • Protect PHI from unauthorized disclosure/use; • Prevent fraud, waste and abuse (via Administrative Simplification); • Make health insurance portable under ERISA; • Move health care onto a nationally standardized electronic billing platform Ref. More on HIPAA: HIPAA resides in which CFR section? - CORRECT ANSWERS 45 CFR sections 164.102 through 164.534 What are the ...

Fraud, Waste, Abuse 2, Fraud Waste and Abuse, Preventing Fraud, Abuse & Waste, Fraud, Abuse, and Waste, Fraud Waste and Abuse 2024 AHIP, fraud, waste, and abuse prevention For 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 ...

e - Answer- Ways to report potential Fraud, Waste, and Abuse (FWA) include: a. Telephone hotlines b. Mail Drops c. In-person reporting to the compliance department/supervisor d. Special Investigations Units (SIUs) e. All of the above false - Answer- Once a corrective action plan is started, the corrective actions must be monitored annually to ensure they are effective. : True False false - Answer- Any person who knowingly submits false claims to the Government is liable...

e - ANSWERWays to report potential Fraud, Waste, and Abuse (FWA) include: a. Telephone hotlines b. Mail Drops c. In-person reporting to the compliance department/supervisor d. Special Investigations Units (SIUs) e. All of the above false - ANSWEROnce a corrective action plan is started, the corrective actions must be monitored annually to ensure they are effective. : True False false - ANSWERAny person who knowingly submits false claims to the Government is liable for f...