HCA Certification Training Exam Actual
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Terms in this set (140)
True or False: True
The ACA requires that all providers
adopt a compliance plan as a
condition of enrollment with
Medicare, Medicaid, and Children's
Health Insurance Program (CHIP).
According to HHS-OIG - what are 1.Protect our programs
three important reasons for proper 2.Protect your patients
documentation in Compliance? 3.Protect the Provider
1.Protect our ___________________
2.Protect your ___________________
3.Protect the ___________________
,At which level of the Medicare Part c. third level of appeal
A or Part B appeals process is the
appeal decision by the Office of
Medicare Hearings and Appeals
(OMHA)?
a. first level of appeal
b. second level of appeal
c. third level of appeal
d. fourth level of appeal
What should CCO be able to do? a. Leadership skills, c. Skills to design and
(What skills should this person implement a compliance program, and d. Be able
have?) to anticipate new risk areas.
Choose all that apply:
a. Leadership skills.
b. Oversee the coding department.
c. Skills to design and implement a
compliance program.
d. Be able to anticipate new risk
areas.
e. Practical experience with
documenting medical necessity.
,What is the appeals process is the Frist level - redetermination by Medicare
appeal decision by the Office of contractor
Medicare Hearings and Appeals Second level - reconsideration by Independent
(OMHA)? contractor
Third appeal - Administrative Law Judge (ALJ)
Frist level - _________________________ hearing
Second level - _________________________ Fourth appeal - review by Medicare Appeals
Third appeal - _________________________ Council
Fourth appeal - _________________________ Fifth appeal - review in Federal District Court
Fifth appeal - _________________________
Which of the following is an c. non-retaliation for whistleblowers
absolute necessity in order to have
a successful Compliance Program?
a. continuous training and
improvements
b. effective reporting path
c. non-retaliation for whistleblowers
d. reliable and equal discipline
A Compliance Program with well d. will not be successful without the proper
written policies and procedures: oversight
a. can be successful if consistently
reviewed and maintained
b. cannot be effective due to the
sheer volume presented
c. will be effective if read by
management
d. will not be successful without the
proper oversight
, A Compliance Officer can achieve a b. increasing management involvement
higher level of compliance and
ethics engagement by:
a. ensuring leadership reads the
policies
b. increasing management
involvement
c. responding to compliance
hotline calls
d. monitoring the code of conduct
Which of the following requires c. Balance Budget Act of 1997
providers to be permanently
excluded from all federal health Also known as a BBA "three strikes rule"
care programs if found guilty of a
healthcare related fraud a third
time:
a. Deficit Reduction Act of 2005
b. False Claims Act
c. Balance Budget Act of 1997
d. Social Security Act section 1128
Which statement is TRUE regarding a. Compliance programs are considered more
compliance programs? dangerous if they are developed but not
implemented.
a. Compliance programs are
considered more dangerous if they
are developed but not
implemented.
b. Compliance programs can detect
but not prevent criminal conduct
c. Compliance programs are only
required by law for healthcare
entities that have more than
$500,000 in annual revenue.
d. Compliance programs are not
mandated by law.
Questions & Answers (Latest 2026 Update) 100%
Guarantee Pass (Verified Answers)
Save
Terms in this set (140)
True or False: True
The ACA requires that all providers
adopt a compliance plan as a
condition of enrollment with
Medicare, Medicaid, and Children's
Health Insurance Program (CHIP).
According to HHS-OIG - what are 1.Protect our programs
three important reasons for proper 2.Protect your patients
documentation in Compliance? 3.Protect the Provider
1.Protect our ___________________
2.Protect your ___________________
3.Protect the ___________________
,At which level of the Medicare Part c. third level of appeal
A or Part B appeals process is the
appeal decision by the Office of
Medicare Hearings and Appeals
(OMHA)?
a. first level of appeal
b. second level of appeal
c. third level of appeal
d. fourth level of appeal
What should CCO be able to do? a. Leadership skills, c. Skills to design and
(What skills should this person implement a compliance program, and d. Be able
have?) to anticipate new risk areas.
Choose all that apply:
a. Leadership skills.
b. Oversee the coding department.
c. Skills to design and implement a
compliance program.
d. Be able to anticipate new risk
areas.
e. Practical experience with
documenting medical necessity.
,What is the appeals process is the Frist level - redetermination by Medicare
appeal decision by the Office of contractor
Medicare Hearings and Appeals Second level - reconsideration by Independent
(OMHA)? contractor
Third appeal - Administrative Law Judge (ALJ)
Frist level - _________________________ hearing
Second level - _________________________ Fourth appeal - review by Medicare Appeals
Third appeal - _________________________ Council
Fourth appeal - _________________________ Fifth appeal - review in Federal District Court
Fifth appeal - _________________________
Which of the following is an c. non-retaliation for whistleblowers
absolute necessity in order to have
a successful Compliance Program?
a. continuous training and
improvements
b. effective reporting path
c. non-retaliation for whistleblowers
d. reliable and equal discipline
A Compliance Program with well d. will not be successful without the proper
written policies and procedures: oversight
a. can be successful if consistently
reviewed and maintained
b. cannot be effective due to the
sheer volume presented
c. will be effective if read by
management
d. will not be successful without the
proper oversight
, A Compliance Officer can achieve a b. increasing management involvement
higher level of compliance and
ethics engagement by:
a. ensuring leadership reads the
policies
b. increasing management
involvement
c. responding to compliance
hotline calls
d. monitoring the code of conduct
Which of the following requires c. Balance Budget Act of 1997
providers to be permanently
excluded from all federal health Also known as a BBA "three strikes rule"
care programs if found guilty of a
healthcare related fraud a third
time:
a. Deficit Reduction Act of 2005
b. False Claims Act
c. Balance Budget Act of 1997
d. Social Security Act section 1128
Which statement is TRUE regarding a. Compliance programs are considered more
compliance programs? dangerous if they are developed but not
implemented.
a. Compliance programs are
considered more dangerous if they
are developed but not
implemented.
b. Compliance programs can detect
but not prevent criminal conduct
c. Compliance programs are only
required by law for healthcare
entities that have more than
$500,000 in annual revenue.
d. Compliance programs are not
mandated by law.
