This initiative was instituted by the government to eliminate fraud and abuse and recover
overpayments, and involves the use of ______________. Charts are audited to identify Medicare
overpayments and underpayments. These entities are paid based on a percentage of money they
identify and collect on behalf of the government.
A. Clinical Data Abstraction Centers (CDAC)
B. Quality Improvement Organizations (QIO)
C. Medicare Code Editors (MCE)
D. Recovery Audit Contractors (RAC)
Question 2
Subcategories of hospital inpatient evaluation and management services include initial hospital care, which includes the __________.
a. admission and discharge from observation/inpatient status on the same day
b. final examination of the patient, discussion of hospital stay with patient or caregiver, instructions for continued care, and preparation of discharge records, prescriptions, and referral forms
c. inpatient's first encounter
d. review of the chart for changes in patient's condition, results of diagnostic studies, and/or reassessment of patient's condition since performance of last assessment
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Warning signs of fraud.
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