Match the following:

Question

A) The Energy Employees Occupational Illness Compensation Program Act
B) internal fraud
C) unbundling
D) underutilization
E) fraud indicator
F) overutilization
G) Occupational Safety and Health Act
H) kickbacks
I) Social Security Disability Insurance
J) upcoding

1) Law that provides the government with the authority to set and enforce safety and health standards for employers
2) Law that provides benefits to eligible and former employees of the U.S. Department of Energy, its contractors and subcontractors, and/or to certain survivors of such individuals.
3) Government program that provides income benefits to people who cannot work because of a medical condition lasting 1 year or more
4) Billing by a provider for a more expensive service than the one performed
5) Illegal incentives paid for patient referrals
6) A sign that suggests that some type of illegal behavior may be occurring; triggers a closer review of a claim or situation
7) Physician orders unnecessary treatments or tests to enable billing for higher fees
8) Providers collude with the insurance company to defraud the employer
9) Physician does NOT provide a sufficient level of treatment because of a fixed capitation payment arrangement
10) Physician performs a single service but bills it as a series of separate procedures

Answer 1

1) G) Occupational Safety and Health Act
2) A) The Energy Employees Occupational Illness Compensation Program Act
3) I) Social Security Disability Insurance
4) J) upcoding
5) H) kickbacks
6) E) fraud indicator
7) F) overutilization
8) B) internal fraud
9) D) underutilization
10) C) unbundling