5 Written questions
5 Matching questions
- The most common forms of "fraud" include:
- Healthcare coverage offered by ___ is called group health insurance.
- The difference between "fraud" & "abuse" is:
- The percentage of costs a patient shares w/the health plan is called__?
- Which is a primary purpose of the patient record?
- a Coinsurance
- b employers
- c -billing for services not furnished
-misrepresenting the diagnosis to justify payment
-soliciting, offering, or receiving a kickback
-falsifying certificates of medical necessity, plans of treatment, & medical records to justify payment
- d the individual's intent
- e ensure continuity of care
5 Multiple choice questions
- an intentional deception misrepresentation that someone makes, knowing it is false, that could result inan unauthorized payment
- involves actions that are inconsistent w/accepted, sound medical, costs to the program through improper payments
- Diagnosis-related groups
- create better access to health insurance, limit fraud & abuse, and reduce administrative costs.
5 True/False questions
Established quality standards for all laboratory testing to ensure the accuracy, reliability, & timelines of patient test results. → Regardless of where the test was performed
The intent of managed health care was to: → create better access to health insurance, limit fraud & abuse, and reduce administrative costs.
Major medical insurance provides coverage for ___ illnesses & injuries, incorporating large deductibles & lifetime maximum amounts. → employers
The first Blue Cross policy was introduced by? → Baylor University in Dallas, Texas
Examples of "abuse" include: → involves actions that are inconsistent w/accepted, sound medical, costs to the program through improper payments