What is FWA
This occurs when a service is billed that was never provided.
What is fraud?
Accepting expensive gifts from a client violates this professional principle.
What are boundaries?
This ensures services meet state and Medicaid standards.
What is Compliance ?
Client information should only be shared with individuals who have this.
What is a valid Release of Information (ROI)?
Services must address needs identified in this document.
What is the assessment?
Billing for more units than were actually provided is an example of this.
What is waste?
Communicating with clients through personal social media accounts is considered…
What is a boundary violation?
Ohio requires annual completion of these to track progress.
What are scales and measures?
Discussing a client in public places (hallways, elevators, stores) violates…
What is HIPAA?
Case management services must be tied directly to this plan.
What is the ISP/ITP?
Allowing someone else to use your login credentials to document services is considered.
What is Abuse?
A case manager gives a client money for food—this crosses which line?
What are ethical and professional boundaries?
Failure to obtain updated consents and ROIs may result in...
What is non-compliance?
Leaving client files or your laptop unattended in a car is a risk to…
What is client confidentiality?
Providing services outside the approved scope may result in…
What is a compliance finding or recoupment?
A case manager documents a visit but leaves early and bills the full time
What is Fraud ?
A dual relationship occurs when a staff member is both a service provider and
What is a friend, family member, or business associate?
Services must be paused if this is missing or outdated.
What is required documentation (ITP, consent, ROI)?
Accessing a client’s chart without a work-related reason is considered…
What is a HIPAA violation?
Services must be reasonable, necessary, and individualized—this defines…
What is medical necessity?
Failure to report known FWA may result in this for the staff member.
What are disciplinary action, termination, or legal consequences?
Types of Boundaries
physical boundaries, intellectual boundaries, emotional boundaries, sexual boundaries, material boundaries and time boundaries.
This concept ensures consistency between assessment, ISP, and notes.
What is the Golden Thread?
Texting identifiable client information on personal devices without encryption violates…
What are HIPAA and agency policy?
When unsure whether an action is ethical or within scope, a case manager should…
What is consult a supervisor and follow agency policy?