Our audits are primarily focused on fee-for-service programs rather than per diem rate programs??
True
The IRS requires that non-profit board members sign this form annually?
Conflict of Interest form
What is a secondary method to identify billing fraud?
Verification Contacts
The False Claims Act requires a provider to report overpayments within how many days of discovery?
60
When investigating fraud we work with the MCO and what state office?
Attorney General
What is our primary method to identify billing fraud?
Pre-billing Audits
If a director signs a contract for janitorial services with his brother's company, without seeking multiple bids for best cost/services, it can be considered what?
Conflict of Interest
Associates disclosing a hotline concern must leave identifying information to allow our team to follow-up with the reporter?
False
What is the agency that oversees all Compliance programs?
Office of Inspector General
What is name of the compliance newsletter?
Compliance Camp
In addition to the hotline, we may also receive notifications of suspected fraud when associates leaving the organization complete this?
Exit Interview Form
Seeking out misuse of corporate funds is a function of the Compliance program?
True
This board sub-committee receives quarterly updates on compliance activities?
Programs Committee
At a minimum, how often is each program audited?
Quarterly
The False Claims Act Qui Tam provision speaks to the protection of individuals reporting false claims. This person is referred to as a?
Whistleblower
If we contract with a vendor to handle our client's information, this must be signed?
Business Associate Agreement
What is the name of our hotline?
Lighthouse
The most important time period to conduct a claims audit is within 1-3 days after the claims have been submitted to our payors?
False
The Compliance office is involved in investigating theft of KidsPeace supplies/resources?
True
Relations between supervisors and line staff is critical to having cohesive teams. Therefore it is considered insubordination if an associate reports an issue to Lighthouse without notifying their supervisor?
False
What is the name of the federal law that protects patient privacy?
HIPAA
In addition to compliance, our department also oversees Licensing and Policies/SOP's?
True
What are the three focus areas of any compliance program?
Fraud, Waste & Abuse
KidsPeace will be penalized if we do not provide an annual training on the Deficit Reduction Act and what other law?
False Claims Act
This document is completed annually and identifies all areas of focus for the coming year?
Compliance Plan
This type of background check is completed monthly to check whether an individual is prohibited from healthcare?
Exclusion Check
The single policy that describes the structure and functions of our office is?
CORP.200 - Compliance Plan