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QuestionAnswer
What is ABN Advance Beneficiary Notice
How many elements in a Compliance Program? 16
What does FERA stand for? Fraud Enforcement and Recovery Act, amends the FCA - False Claim Act in 2009
What are the Code of Conduct areas? Human Resources Privacy/ confidentiality Quality of care Billing/ Coding Conflicts of Interest Laws/Regulations
What is OIG? Office of Inspector General
What makes up the OIG Work Plan? 1. Outpatient Evaluation and management services billed at the new patient rate. 2. Indirect medical education payments. 3. Medicare Costs associated with defective medical devices. 4. Comparison of provider-based and free standing clinics. 5. Nationw
What are the secondary payer situations? working aged, accident or other liability, disability ESRD
What does DME stand for? Durable Medical Equipment, examples, wheelchairs, beds, oxygen tanks
What does CMS stand for? Centers for Medicare and Medicaid Services
What does LCD and NCD stand for? Local Coverage Determinations, National Coverage Determinations, guidelines for which procedures, diagnoses are covered
What does MSP stand for? Medicare Secondary Payer.
List four situations for MSP? working aged, accident/liability, ESRD, disability
HMO Health Maintenance Organization
PPO Preferred provider Organization
POS point of service plan
CDHP Consumer Directed Health Plans
DRG Diagnosis related group
APC Ambulatory Payment Classification
EMTALA Emergency Medical Treatment And Labor Act
MS-DRG Medicare Severity Diagnosis-Related Group
LGHP Large group health plan
Created by: kurchek
 

 



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