OIG Study guides, Class notes & Summaries

HFMA CRCR Exam with 100% Correct Answers 2023 Through what document does a hospital establish compliance standards? - Correct answer-code of conduct What is the purpose OIG work plant? - Correct answer-Identify Acceptable compliance programs in various provider setting If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? - Correct answer-Non-diagnostic service provided on Tuesday through Friday What does a modifier al...

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). - Answer- True ref. ACA section 6102 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) - Answer- 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 app...

Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - Yes According to TJC, who may amend the medical staff bylaws? - Governing body/board. Failure to meet the established qualifications and criteria for appointment should be reported to whom? - The applicant NCQA requires the MCO to obtain a minimum of how may years of work history? - Five years According to the NCQA what policy must an organization have in place to obtain approval to...

CHAA Exam Questions And Answers With Verified Solutions 2023 Medicare Two-midnight rule What is the CMS rule that states that an inpatient stay must cross two midnights to be paid for under Medicare part A? OIG Which program is responsible for protecting the integrity of the Hospital and Human Services (HHS) program by detecting and preventing fraud? 7 An effective compliance level has a minimum of how many levels? Creating standards of privacy Part of an effective compliance program Not...

Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - Yes According to TJC, who may amend the medical staff bylaws? - Governing body/board. Failure to meet the established qualifications and criteria for appointment should be reported to whom? - The applicant NCQA requires the MCO to obtain a minimum of how may years of work history? - Five years According to the NCQA what policy must an organization have in place to obtain approval to...

Chapter 3 CPCO - Other Applicable OIG Compliance Program Guidance with complete solution

Chapter 3 CPCO - Other Applicable OIG Compliance Program Guidance with complete solution

Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - ️️Yes According to TJC, who may amend the medical staff bylaws? - ️️Governing body/board. Failure to meet the established qualifications and criteria for appointment should be reported to whom? - ️️The applicant NCQA requires the MCO to obtain a minimum of how may years of work history? - ️️Five years According to the NCQA what policy must an organization have ...

CPCO EXAM 2024 WITH 100% CORRECT ANSWERS Does Medicare pay for all tests ordered by Providers? - correct answer No, they need to determine if it's covered and medically necessary. For larger physician practices, how often does the OIG suggest reporting compliance activities to the board of directors? - correct answer Regularly According to the OIG, medically unnecessary services can be billed to Medicare for what purpose? - correct answer To receive a denial so a claim can be submit...

HFMA CRCR exam 2024 with 100% correct answers