Section V - Quiz

5 Questions | Total Attempts: 134

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Section V - Quiz - Quiz

FRAUDULENT AND IMPROPER BILLING PRACTICES


Questions and Answers
  • 1. 
    What is the definition of fraud?
    • A. 

      Any lie or false statement to another person

    • B. 

      Any deliberate conduct that is inconsistent with sound fiscal, business, or medical practices, and results in an unnecessary financial cost to a federal health care program

    • C. 

      An intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person.

    • D. 

      Any plan to unlawfully take or steal money from another person or institution

  • 2. 
    In order to be medically necessary, a cardiac monitoring service must be ordered by a physician, physician assistant, nurse practitioner, or certified technician 
    • A. 

      True

    • B. 

      False

  • 3. 
    Fraudulent and improper billing practices do not include which of the following:  
    • A. 

      Billing for services not rendered

    • B. 

      Down-coding

    • C. 

      Billing for medically unnecessary services

    • D. 

      Upcoding

  • 4. 
    Unbundling describes which of the following improper billing practices?
    • A. 

      Using the CPT-4 procedure code with the highest reimbursement rate to bill a medical service

    • B. 

      Using multiple CPT-4 procedure codes to bill the separate components of a single complex medical service

    • C. 

      Using a single CPT-4 procedure code to bill numerous services that are required to be performed and separately billed using different CPT-4 procedure codes

    • D. 

      Using multiple CPT-4 procedure codes to separately bill components of a medical service that are performed together and are required to be billed under the single CPT-4 procedure code assigned to the service

  • 5. 
    Medicare covers and pays for which of the following services or supplies?
    • A. 

      Free services and supplies

    • B. 

      Experimental services and supplies

    • C. 

      Services and supplies needed to treat an existing illness or injury

    • D. 

      Unnecessary services and supplies

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