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AAPC test - Chapter 4 - 4/4 2025 Questions and Answers arah, Compliance Officer for Apple Hospital, explains to the physicians on staff that _________ can occur when the same service is billed to Medicare and then billed to a private insurance company or to the patient. - ....ANSWER ...-Selected Answer: double billing What is the maximum amount of days, after determining that there is credible evidence of fraudulent conduct, should a billing company take to notify federal and state authorities regarding the violation? - ....ANSWER ...-60 Which, of the following, is NOT a key risk area identified for third-party medical billing companies by the OIG Compliance Program Guidance? - ....ANSWER ...-Billing for items or services not actually documented;• Unbundling;• Upcoding, such as, for example, DRG creep;• Inappropriate balance billing;• Inadequate resolution of overpayments;• Lack of integrity in computer systems;• Computer software programs that encourage billing personnel to enter data in fields indicating services were rendered though not actually performed or documented;• Failure to maintain the confidentiality of information/records;• Knowing misuse of provider identification numbers, which results in improper billing;• Outpatient services rendered in connection with inpatient stays;• Duplicate billing in an attempt to gain duplicate payment;• Billing for discharge in lieu of transfer;• Failure to properly use modifiers;• Billing company incentives that violate the anti-kickback statute or other similar Federal or State statute or regulation;• Joint …FOR STUDENTS ONLY…©️2025 ALL RIGHTS RESERVED… 1