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7/18/22, 9:38 PM Compliance Program Implementation and Ethical Decision Making Scoring Guide

https://courserooma.capella.edu/bbcswebdav/institution/BHA-FPX/BHA-FPX4006/220100/Scoring_Guides/a02_scoring_guide.html 1/1

Compliance Program Implementation and Ethical Decision Making Scoring Guide

CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED

Describe major categories of health care fraud and abuse, including the billing practice known as upcoding.

Does not describe major categories of health care fraud and abuse, including the billing practice known as upcoding.

Lists but does not describe major categories of health care fraud and abuse, including the billing practice known as upcoding. Omissions and/or errors exist.

Describes major categories of health care fraud and abuse, including the billing practice known as upcoding.

Analyzes major categories of health care fraud and abuse, including the billing practice known as upcoding. Analysis includes multiple examples, specifics, and references to current, authoritative sources, such as government websites.

Propose a list of evidence-based recommendations based on information from the Office of the Inspector General to identify and address upcoding within a health care organization.

Does not propose a list of evidence- based recommendations based on information from the Office of the Inspector General to identify and address upcoding within a health care organization.

Proposes a list of recommendations to identify and address upcoding within a health care organization. Not all recommendations are evidence-based or based on information from the Office of the Inspector General. Omissions and/or errors exist.

Proposes a list of evidence-based recommendations based on information from the Office of the Inspector General to identify and address upcoding within a health care organization.

Proposes a list of multiple evidence-based recommendations based on information from the office of the Inspector General to identify and address upcoding within a health care organization. Recommendations include multiple examples, specifics, and references to current, authoritative sources, such as government websites.

Provide a synopsis of five laws relating to health care fraud and abuse.

Does not provide a synopsis of five laws relating to health care fraud and abuse.

Provides a synopsis of five laws relating to health care fraud and abuse; however, omissions and/or errors exist.

Provides a synopsis of five laws relating to health care fraud and abuse.

Provides a succinct synopsis of five laws relating to health care fraud and abuse. Synopsis includes multiple examples, specifics, and references to current, authoritative sources, such as government websites.

Explain one law that pertains to the practice of upcoding.

Does not explain one law that pertains to the practice of upcoding.

Attempts to explain one law that pertains to the practice of upcoding; however, omissions and/or errors exist.

Explains one law that pertains to the practice of upcoding.

Explains one law that pertains to the practice of upcoding. Explanation includes multiple case examples, specifics, and references to current, authoritative sources, such as government websites.

Develop a clear, concise, organized, and generally error- free workplace brief that provides evidence-based recommendations about how to identify and address the incorrect billing practice of upcoding.

Does not develop a clear, concise, organized, and generally error- free workplace brief that provides evidence-based recommendations about how to identify and address the incorrect billing practice of upcoding.

Attempts to develop a clear, concise, organized, and generally error-free workplace brief that provides evidence- based recommendations about how to identify and address the incorrect billing practice of upcoding; however, significant lapses, omissions, and/or errors exist.

Develops a clear, concise, organized, and generally error- free workplace brief that provides evidence-based recommendations about how to identify and address the incorrect billing practice of upcoding.

Develops a clear, concise, organized, and error-free workplace brief that provides evidence-based recommendations about how to identify and address the incorrect billing practice of upcoding. Brief includes multiple case examples, specifics, and references to current, authoritative sources, such as government websites.