What do you mean by Electronic Business Information?
a. Electronic business information is exchanged between two or more businesses. b. Customers' funds-related transactions are electronically transmitted and processed. c. Products sold on central web servers can be accessed by users any time. d. Entered sales data are electronically transmitted via a centralized network to a central processor.
Why are B2B transactions generally very reliable?
III.B2B transactions occur electronically and are generally very reliable because computers are very precise and there is no opportunity for human error. a. I and II. b. II and III.
How are customers' funds-related transactions processed?
Customers' funds-related transactions are electronically transmitted and processed. c. Products sold on central web servers can be accessed by users any time. d. Entered sales data are electronically transmitted via a centralized network to a central processor.
Which CMS product describes whether specific medical items service treatment procedures or technologies are considered medically necessary under Medicare?
The National Coverage Determinations Manual describes whether specific medical items, services, treatment procedures or technologies are considered medically necessary under Medicare.
How many components are included in an effective compliance plan quizlet?
What are the seven basic compliance program elements? Written standards of conduct and policies, designation of a chief compliance officer, effective education and training, Audits to monitor compliance, helpline, appropriate disciplinary mechanisms, investigation and remedi of system problems.
What form is used to submit a providers charge to the insurance company?
Professional paper claim form (CMS-1500)
How many components are included in an effective compliance plan AAPC?
The seven, basic elements of healthcare compliance defined by OIG include: Conducting internal monitoring and auditing. Implementing compliance and practice standards. Designating a compliance officer or contact.
What are the benefits of an active compliance plan?
An effective compliance plan keeps pace with changing government regulations, payer requirements, office operations, and technology. Compliance plan updates should acknowledge government regulation and payer requirement changes, but should also incorporate lessons from within your own office or facility.
Which of the following provides guidance for the healthcare organization and staff to ensure compliance and that policies are followed?
Which of the following provides guidance for the healthcare organization and staff to ensure compliance and that policies are followed? An employee handbook and compliance plan provide written sets of policies and procedures for organizations and employees to follow.
What document assists provider offices with the development of compliance manuals?
72 Cards in this SetDescription of a Medically necessary serviceUsing the least radical service/procedure that allows for effective treatment of the patient's complaint or condition.What document has been created to assist physician offices with the development of compliance manuals?OIG Compliance Plan Guidance70 more rows
What is the standard format used for submission of electronic claims for professional healthcare services?
837PThe 837P (Professional) is the standard format health care professionals and suppliers use to send health care claims electronically.
How do providers submit claims to Medicare?
Contact your doctor or supplier, and ask them to file a claim. If they don't file a claim, call us at 1-800-MEDICARE (1-800-633-4227). TTY: 1-877-486-2048. Ask for the exact time limit for filing a Medicare claim for the service or supply you got.
What are the benefits of a coding compliance plan?
The Benefits of a Coding Audit:Prevents fines and/or jail time.Improves your ROI (are you leaving money on the table?)Improves medical record accuracy.Helps with training and education.Plays integral role in maintaining a culture of compliance.Keeps you up-to-date on coding rules and regulations.More items...•
What is a compliance program in a healthcare organization?
A Compliance Program is a formalized effort to prevent, detect, and respond to business conduct that is inconsistent with federal and state laws and with an organization's values. The healthcare industry typically receives significant financial support from the government through such programs as Medicare and Medicaid.
Which of the following is included as part of the seven elements of a compliance program as indicated by the US Sentencing Guidelines quizlet?
Seven Elements of an Effective Compliance ProgramImplementing Policies, Procedures, and Standards of Conduct. ... Designating a Compliance Officer and Compliance Committee. ... Training and Education. ... Effective Communication. ... Monitoring and Auditing. ... Disciplinary Guidelines. ... Detecting Offenses and Corrective Action.