Jackline98

Federal Sentencing Guidelines - Culpability Score Aggravating Factors - ️️1. upper-level employee participates, condones, or ignores offense 2. repeat offense 3. hinder investigation 4. awareness and tolerance of violation is pervasive Federal Sentencing Guidelines - Culpability Score Mitigating Factors - ️️1. effective compliance program 2. reported promptly 3. cooperation with investigation 4. accept responsibility Federal Sentencing Guidelines - Seven Elements of an Effect...

Chapter 8 Federal Sentencing Guidelines (FSG) - ️️Guidelines and policy in this section apply to sentencing in federal criminal prosecution when the convicted defendant is an organization FSG- 4 factors that increase ultimate punishment of an organization - ️️1.Involvement in or tolerance of criminal activity 2.Prior history of the organization 3.The violation of an order 4.The obstruction of justice FSG- The two factors that mitigate the ultimate punishment of an organization...

True or False: The ACA requires that all providers adopt a compliance plan as a condition of enrollment with Medicare, Medicaid, and Children's Health Insurance Program (CHIP). - ️️True According to HHS-OIG - what are three important reasons for proper documentation in Compliance? 1.Protect our ___________________ 2.Protect your ___________________ 3.Protect the ___________________ - ️️1.Protect our programs 2.Protect your patients 3.Protect the Provider At which le...

At which level of the Medicare Part A or B appeals process is the appeal reconsidered by a qualified independent contractor? a. first level appeal b. second level appeal c. third level appeal d. fourth level appeal - ️️b. second level appeal There are five levels of appeal. First level entails a redetermination of claim; second level involves reconsideration by a qualified independent contractor; third level includes a hearing overseen by admin law judge; fourth level is a review of ...

True or False: The ACA requires that all providers adopt a compliance plan as a condition of enrollment with Medicare, Medicaid, and Children's Health Insurance Program (CHIP). - ️️True ref. ACA section 6102 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) - ️️1.Protect our programs 2.Protect your patients 3.Protect the Provider At which level of the Medicare Part A or Part B appeals process is the appeal ...

Which of the following is a goal of the minimum necessary requirement under the HIPAA Privacy Rule? - ️️Ensure that all workforce members have the same access to PHI within an organization. A patient is checking in at the registration desk and overhears a conversation between another patient and the billing specialist regarding a specific diagnosis that is not being covered under the patient's insurance. This is an example of what type of disclosure? - ️️Incidental Which of the fo...

Federal Sentencing Guidelines - Culpability Score Aggravating Factors - ️️1. upper-level employee participates, condones, or ignores offense 2. repeat offense 3. hinder investigation 4. awareness and tolerance of violation is pervasive Federal Sentencing Guidelines - Culpability Score Mitigating Factors - ️️1. effective compliance program 2. reported promptly 3. cooperation with investigation 4. accept responsibility Federal Sentencing Guidelines - Seven Elements of an Effect...

Stark or Physician Self-Referral Law - ️️The Omnibus Budget Reconciliation Act bans physicians from referring patients to receive "designated health services" to any entity with which the physician has a financial relationship. Designated health services include lab testing, imaging services, physical or occupational therapy, etc. (civil only, medicare/medicaid only, strict liability) Anti-Kickback Statute (AKS) - ️️Prohibits the solicitation, receiving, offering, or paying any remu...

HIPAA became law - ️️1996 What is the purpose of HIPAA? - ️️• 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 - ️️purpose of this subtitle to improve the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, and the efficiency and effectiveness of the health care system, by encouragin...

What is the purpose of HIPAA? - ️️• 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? - ️️45 CFR sections 164.102 through 164.534 What are the subparts of HIPAA part 164? - ️️HIPAA - 45 CFR 164, subparts: Subpart A - ...

HIPAA became law - ️️1996 What is the purpose of HIPAA? - ️️• 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 - ️️purpose of this subtitle to improve the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, and the efficiency and effectiveness of the health care system, by encouragin...

fight or flight response - ️️Sympathetic Rest and Digest - ️️Parasympathetic What regulates involuntary movement? - ️️Autonomic What system regulates voluntary movements? - ️️Somatic What is expected prognosis of ALS patient? - ️️3-5 years What is the priority need for late parkinson's patients? - ️️Airway protection What is the 1st sign of Myasthenia Gravis? - ️️Eye Drooping What type of diet should be given to seizure patients? - ️️Ketogeni...

Diarrhea - ️️bowel movements that are watery and/or frequent. Document - ️️in medical settings, to write down facts or statements describing assessments, observations, and care provided to patients. Do not resuscitate (DNR) - ️️an advance directive stating a refusal of cardiopulmonary resuscitation if the heart or breathing stops. chronic obstructive pulmonary disease (copd) - ️️a progressive disease that makes it hard to breathe. "Progressive" means the disease gets w...

AIDS infection - ️️Bacterial, Viral, Fungal, Parasitic AIDS dementia - ️️causes Encephalopathy, 15% effected ALS (amyotrophic lateral sclerosis) 1st symptom - ️️swallowing difficulty followed by distal weakness Cerebral Metastases - ️️Brain mets account for 40% of all Cancer patients. Cerebral Metastases symptoms - ️️HA initial complaint, N/V, confusion, lethargy Leukemia 2 types - ️️chronic and acute Leukemia Clinical Manifestations - ️️Infection, f...

xerostomia - ️️Dry mouth syndrome, leads to decreased swallowing ability, increased dental caries, gum, tongue and oral lesions, infections, bad breath, changes in taste and alterations in speech and voice functions. Social decline pyschosocial complication. xerostomia non-pharmacological treatments - ️️oral swabs, peppermint water, vitamin c, chewing gum/mints, acupuncture, diet modification, humidity Percentage of HIV infection related pain - ️️50% directly related to infecti...

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