Question
1. What is the difference between Medicare Advantage and traditional Medicare? 2. What is a special investigation unit (SIU)? 3. Under certain circumstances, the CMS
1. What is the difference between Medicare Advantage and traditional Medicare?
2. What is a special investigation unit (SIU)?
3. Under certain circumstances, the CMS may wish to perform its own audits of a Sponsors or FDRs activities pertaining to any aspect of the services provided or amounts payable under its Medicare contract. It has the right to do this, and the Sponsor must allow access to any auditor acting on behalf of the CMS or other federal government agency to conduct an on-site audit. What items will be the subject of a typical CMS audit?
4. It is not always easy for a plan sponsor to identify which of its contracted partners qualify as FDRs. The CMS recommends that the Sponsor take certain factors into account. Name four of them and explain.
Step by Step Solution
There are 3 Steps involved in it
Step: 1
Get Instant Access to Expert-Tailored Solutions
See step-by-step solutions with expert insights and AI powered tools for academic success
Step: 2
Step: 3
Ace Your Homework with AI
Get the answers you need in no time with our AI-driven, step-by-step assistance
Get Started