Across
- 2. - Improper billing practices that are not necessarily intentional
- 3. - Law prohibiting physicians from referring patients to entities where they have financial interest
- 4. - Federal insurance program primarily for people 65 and older
- 7. - Intentional deception for financial gain
- 10. - Payment method where providers are paid a fixed amount per patient per month
- 12. - Payment details sent from payer to provider after claim processing
- 13. - Diagnosis-based hospital payment system under Medicare
- 14. - State and federally funded insurance program for low-income individuals
- 15. - Government agency that investigates healthcare fraud and abuse
Down
- 1. - Healthcare delivery system that controls cost and access to services
- 5. - Document that explains how a claim was processed by insurance
- 6. - Organized effort to ensure laws and regulations are followed
- 8. - Billing separately for procedures that should be combined
- 9. - Provision allowing private individuals to sue on behalf of the government
- 11. - Charging for a higher level service than provided