Compliance Week Crossword Puzzle

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Across
  1. 2. Knowingly and willfully executing, or attempting to execute a scheme to deceive or cheat a healthcare program
  2. 4. Series of actions designed to provide reasonable assurance regarding the achievement of objectives
  3. 8. Compliance Department activities are part of a company's ______ Line of Defense
  4. 9. Overutilization of services or misuse of resources resulting in unnecessary costs
  5. 13. A Medicare Second level appeal
  6. 15. List of drugs the plan covers
  7. 16. An action taken to change a binding determination
  8. 18. System that CMS releases important memos
  9. 20. Procedure dealing with the review of an adverse initial determination
  10. 21. Possibility that an event will occur and adversely affect achievement of objectives
  11. 26. Initial request that must be completed within 24 hours
  12. 27. Conforming to applicable laws, or meeting requirements of accepted policies and practices
  13. 29. Code of _______ guides our behavior in the workplace
  14. 30. Person who can speak on behalf of a member
  15. 31. Expedited appeals must be accepted when requested this way
  16. 32. Established data privacy and information security requirements for safeguarding PHI
Down
  1. 1. Rules, principles and standards for deciding what is morally right or wrong when doing business
  2. 3. A Medicare First level appeal
  3. 5. An expression of dissatisfaction
  4. 6. One of the 7 Elements of Compliance dealing with prompt response to detected deficiencies
  5. 7. Any impermissible acquisition, access, use or disclosure of unsecured PHI that compromises the security or privacy of the PHI
  6. 10. Who is responsible for compliance?
  7. 11. Number of days from the date of the denial notice a Medicare member has to file an appeal
  8. 12. Paying for items or services when there is no legal entitlement to that payment
  9. 14. Conduct not conforming to law, federal health care program requirements, or Elixir's ethical and business policies
  10. 17. Personal information that identifies an individual
  11. 19. Suspension of payment, enrollment, and/or marketing activities
  12. 22. A value that is a key part of Elixir's foundation
  13. 23. Standard appeals may be accepted when requested this way
  14. 24. Information ________ is about protecting our data and electronic system
  15. 25. Initial request that must be completed within 72 hours
  16. 28. An untimely Medicare request that gets sent to the Independent Review Entity