Fraud and abuse in healthcare is a small issue with little financial or healthcare ramifications.

There are four levels of appeal for Medicare claims processing.

What are the five most important federal fraud and abuse laws that apply to physicians?

Define Fraud and Abuse. Give me an example of fraud and abuse in health care billing.

The false claims act protects the government from being overcharged or being billed for poor services.

Individual-specific information that is protected under HIPAA is known as Protected Health Information

Name one of the health insurance claim forms that providers submit to the insurance companies

Coders and billers should strive for the appropriate coding levels to ensure optimum payments?

Case 4: At a family reunion, you see an uncle with a history of COPD, GERD, and a L MCA CVA 4 years ago who is reporting difficulty swallowing. He reports coughing and choking with solids and liquids, a globus sensation at the level of the throat, and waking in the morning with a sour taste in his mouth. As the family’s resident ‘swallow-ologist’ he comes to you for advice.  b). He tells you that he is scheduled for a modified barium swallowing evaluation with a SLP this coming week.  What would you recommend be included in the evaluation? What would you expect to see during the assessment to confirm your suspicions from question (a). 

Case 1: A 65 year-old male with a 15 year history of Parkinson’s disease presents to your clinic with complaints of gradually progressive swallowing difficulty for the past 5 years. b). What are two compensations that you may attempt during the swallowing evaluation to augment airway compromise?