Compliance Training Corporate Study
Guide.
Compliance Programs demonstrate our good faith effort to fulfill our legal duty and eliminate
improper or unethical conduct. Which of the following is not part of a Compliance Program's
purpose? - Answer Increase rev
Use the drop-downs to match each Element of an Effective Compliance Program to its
description. - Answer Policies & proc.: clearly written
Oversight: chief
Training & Ed: topical instructions
Lines of comm: routes used
Auditing: comprehensive risk assessments
Enforcement: corrective action
Response: investigate
Medicare Advantages (MA) programs arrange for and provide health care services to
beneficiaries who enroll in a MA plan. MA plans are: - Answer Private, Medicare-approved
insurance companies.
Medicare Advantage Plans must cover all services Medicare covers with the exception of
hospice care. Use the drop-downs to match the Medicare Part designation to its service. (Note
that each option is used only once.) - Answer A: inpatient
B: outpatient
C: medicare
D: scripts
Fraud involves which of the following? - Answer Taking inappropriate actions.
Intentional deception or misrepresentation
.
Making false statements to obtain payment for which you are not entitled.
A provider ordering an unusually high number of lab tests for his patients may be a sign of
potential fraud. - Answer True
Guide.
Compliance Programs demonstrate our good faith effort to fulfill our legal duty and eliminate
improper or unethical conduct. Which of the following is not part of a Compliance Program's
purpose? - Answer Increase rev
Use the drop-downs to match each Element of an Effective Compliance Program to its
description. - Answer Policies & proc.: clearly written
Oversight: chief
Training & Ed: topical instructions
Lines of comm: routes used
Auditing: comprehensive risk assessments
Enforcement: corrective action
Response: investigate
Medicare Advantages (MA) programs arrange for and provide health care services to
beneficiaries who enroll in a MA plan. MA plans are: - Answer Private, Medicare-approved
insurance companies.
Medicare Advantage Plans must cover all services Medicare covers with the exception of
hospice care. Use the drop-downs to match the Medicare Part designation to its service. (Note
that each option is used only once.) - Answer A: inpatient
B: outpatient
C: medicare
D: scripts
Fraud involves which of the following? - Answer Taking inappropriate actions.
Intentional deception or misrepresentation
.
Making false statements to obtain payment for which you are not entitled.
A provider ordering an unusually high number of lab tests for his patients may be a sign of
potential fraud. - Answer True
