100s (100-103.5) Flashcards
What does the departments compliance program include as it pertains to billing?
1: Designation of a compliance officer
2: Core compliance standards (correct medical coding and billing, documentation, exclusion list)
3: Id and correct issues
What are the compliance officers responsibilities?
1: Get certified
2: Develop implement training
3: Develop implement auditing program
4: Report offenses
5: Annually review
What is a pre-billing review?
1: Determine whether a claim can be submitted for payment as is, or errors need to be corrected
2: Done monthly on sample basis
What is a post billing review?
1: To determined if claim was appropriately billed and paid.
2: Done quarterly on sample basis
What is the list of excluded individuals and entities LEIE?
Persons or organizations that cannot participate in federal healthcare programs (checked quarterly)
How often does the compliance officer do a risk assessment?
Annually
What are our values?
1: We are Professionals
2: We are all valued and diverse
3: Strive for excellence
What is our performance guarantee?
Do what we say we will do, try our best to do them, care about customers, property and each other
What is CARE
1: Compassion
2: Accountability
3: Respect
4: Excellence
How often does the labor management team meet?
Quarterly to discuss department issues
What is Meet and Confer?
Formal negotiations between labor and management in good faith
What are the two major areas for accreditation?
1: Self Assessment
2: Standards of Response Coverage
All commercial occupancies in Mesa are categorized by risk. What are the categories?
1: Maximum Risk (High Prob High Con)
2: High / Special Risk (Low Prob High Con)
3: Low Risk
What is High Probability High Consequence?
High Probability: High risk for fire
High Consequence: High risk of life or property
What are examples of Maximum risk?
1: Non sprinkler 3 or more stories
2: High or mid rise
3: Warehouse heavy fire load
4: Explosive manufacturer
5: Toxic
6: Vacant no pre plan
What is examples of High special risk (Low Prob High Con)
1: Large assembly with fire protection
2: Stadium amusement park
3: Schools
4: Sprinkler nursing home
5: Group home
6: Restaurant
7: Single family dwelling
What are examples of Low RIsk (Low Prob Low Con)
1: Small commercial
2: Detached Garage
3: Carports
4: Storage facility