Question 1_4 out of 4 points
What is the value of a remittance advice?
Selected Answer: c.
It states what will be paid and why any changes to
... [Show More] charges were made.
Correct Answer: c.
It states what will be paid and why any changes to charges were made.
Response
Feedback:
Rationale: The determination of the payer is sent to the provider in the form of a remittance
advice. The remittance advice explains the outcome of the insurance adjudication on the claim,
including the payment amount, contractual adjustments and reason(s) for denial.
Question 2_4 out of 4 points
What is the purpose of National Coverage Determinations?
Selected Answer: d.
To explain CMS policies on when Medicare will pay for items or services.
Correct Answer: d.
To explain CMS policies on when Medicare will pay for items or services.
Response
Feedback:
Rationale: National Coverage Determinations (NCD) explain CMS policies on when
Medicare will pay for items or services.
Question 3_4 out of 4 points
How many components are included in an effective compliance plan?
Selected Answer: d.
7
Correct Answer: d.
7
Response
Feedback:
Rationale: The following list of components, as set forth in previous OIG Compliance Program
Guidance for Individual and Small Group Physician Practices, can form the basis of a voluntary
compliance program for a provider practice:
• Conducting internal monitoring and auditing through the performance of periodic audits;
• Implementing compliance and practice standards through the development of written
standards and procedures;
• Designating a compliance officer or contact(s) to monitor compliance efforts and enforce
practice standards;
• Conducting appropriate training and education on practice standards and procedures;
• Responding appropriately to detected violations through the investigation of allegations
and the disclosure of incidents to appropriate Government entities;
• Developing open lines of communication, such as (1) discussions at staff meetings
regarding how to avoid erroneous or fraudulent conduct, and (2) community bulletin boards,
to keep practice employees updated regarding compliance activities; and
• Enforcing disciplinary standards through well-publicized guidelines.
These seven components provide a solid basis upon which a provider practice can create a
compliance program.
Question 4_4 out of 4 points
EHR stands for:
Selected Answer: a.
Electronic health record
Correct Answer: a.
Electronic health record
Response Feedback: Rationale: EHR stands for electronic health record
Question 5_4 out of 4 points
The minimum necessary rule is based on sound current practice that protected health information should NOT
be used or disclosed when it is not necessary to satisfy a particular purpose or carry out a function. What does
this mean?
Selected
Answer:
b.
Providers should develop safeguards to prevent unauthorized access to protected health
information.
Correct Answer: b.
Providers should develop safeguards to prevent unauthorized access to protected health
information.
Response
Feedback:
Rationale: The minimum necessary standard requires covered entities to evaluate their
practices and enhance safeguards as needed to limit unnecessary or inappropriate access to
and disclosure of protected health information. Only those individuals whose job requires it
may have access to P [Show Less]