Upcoding Study guides, Class notes & Summaries

NRNP 6568 Final Exam Test Questions With Correc t Answers 2023 | 2024 (Already Graded) If an NP is at a social gathering and someone casually asks his/her medical opinion, that NP could be liable if something goes wrong. True or false? Selected Answer: True Answers: True Fals e  Question 10 1 out of 1 points Telemedicine is defined as Selected Answer: When care is provided remotely and the provider and patient are not physically present with each other Answers: When care is pro...

Medical Billing and Coding Certificate Exam Already Passed Chief Complaint (element 1 of history) History of present illness, Review symptom, Past, Family, and Social history History Levels (Element 2 of history) and Examination Levels (Element 3 of History) Problem focused, expanded problem focused, detailed, Comprehensive Medical Decision Making Complexity Levels (element 4 of history) Straightforward, Low, Moderate, High straightforward Minimal diagnosis Minimal...

Medical Coding and Billing Certification (MCBC) Study Guide I The services medically necessary for diagnostic code linkage - correct answer What must a coder understand in order to determine the correct diagnosis code assignment? Correctly identifying primary and secondary insurance policies in order to preserve coordination of benefits - correct answer Avoiding the duplication of benefits paid by the primary and secondary insurance is achieved by: Use the combination code - correct answe...

NRNP 6568 FINAL TEST QUESTIONS WITH CORRECT ANSWERS 2023 | 2024 (Already Graded). Release of information (ROI) to third parties requires authorization by the patient or his or her legal representative. True or False? Selected Answer: True Answers: True Fals e  Question 2 1 out of 1 points When giving patients written information, what is the suggested reading level for that health information? Selected Answer: 5 th grade Answers: 10th gra de 7 th grad e 1 st grad e 5 t...

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...

A new movement known as the Mental Health Reform became popular throughout the country at the end of the 19th century. Which initiative did this reform accomplish for health care? A. It provided health insurance for mental health B. It recognized that obesity was a mental disorder C. It stated that mental health treatment was primary care D. It addressed the need to improve mental health treatment. - ANSWER-D The federal government amended the Social Security Act in 1965 to provid...

If a patient has an excision of a malignant lesion of the skin, the CPT code is determined by the body area from which the excision occurs and which of the following? A) Length of the lesion as described in the pathology report B) Dimension of the specimen submitted as described in the pathology report C) Width times the length of the lesion as described in the operative report D) Diameter of the lesion as well as the margins excised as described in the operative report (Ans - D) Diameter...

HCF Investigator Assumptions - *General knowledge of the Health care Delivery System *Health plan policy and procedures relative to the delivery of services *Able to identify Red Flags, behaviors & indicators of health care fraud schemes Know applicable federal & state laws related to health care fraud *Law enforcement & regulatory agencies that have oversight responsibilities for HCF *Local & regional investigative groups that have similar interests Fraud, by it's very nature...

The overutilization or inappropriate utilization of services and misuse of resources, typically not a criminal or intentional act is called which of the following? a. Fraud b. Abuse c. Waste d. Audit (Ans- c Waste is the overutilization or inappropriate utilization of services and misuse of resources, and typically is not a criminal or intentional act. Waste includes practice like over prescribing and ordering tests inappropriately (Foltz et al. 2016, 448). Examples of high-risk bill...

AHFI Examination Prep Course with Certified Solutions HCF Investigator Assumptions *General knowledge of the Health care Delivery System *Health plan policy and procedures relative to the delivery of services *Able to identify Red Flags, behaviors & indicators of health care fraud schemes Know applicable federal & state laws related to health care fraud *Law enforcement & regulatory agencies that have oversight responsibilities for HCF *Local & regional investigative groups ...