AHFI EXAM TEST BANK SOLVED
QUESTIONS WITH FULL SOLUTION
VERIFIED RESPONSES GRADED A+
⩥ 6 Determination of Action.
Answer: Evaluating the totality of the documented case facts to
determine the best action to resolve the investigation.
⩥ Detection phase involves.
Answer: Behavioral & Pattern Analysis
Emerging Schemes
Hot Spots
LE = Law Enforcement (Intelligence, Vice, OC)
Payer: Sales, Claims, Provider Relations, Legal
Hotline (Patients, Providers & Employees)
NHCAA (RIA & SIRIS)
Information Sharing (SIU, Anti-fraud Organizations, Task Force)
,⩥ -opexy.
Answer: surgical fixation
⩥ Considerations - factors to consider.
Answer: Overall strength of case
Credible witnesses
Jurisdiction or venue
Possible defenses
Amount and nature of the evidence
Circumstantial versus direct
evidence
Nature of the alleged activity
State or Federal laws
Sentencing guidelines
⩥ -oplasty.
Answer: surgical repair
⩥ burden of proof in a civil case.
Answer: preponderance of the evidence
, Means that one side has more evidence in its favor than the other, even if
by the smallest degree
Lower burden of proof
⩥ -otripsy.
Answer: crushing or destroying
⩥ Burden of proof in a criminal case.
Answer: beyond a reasonable doubt
A reasonable doubt is a doubt that would prevent a reasonable and just
Judge or jury from coming to a conclusion
Higher burden
⩥ -algia.
Answer: pain
⩥ Possible Resolutions.
Answer: Criminal Referral
Civil referral
QUESTIONS WITH FULL SOLUTION
VERIFIED RESPONSES GRADED A+
⩥ 6 Determination of Action.
Answer: Evaluating the totality of the documented case facts to
determine the best action to resolve the investigation.
⩥ Detection phase involves.
Answer: Behavioral & Pattern Analysis
Emerging Schemes
Hot Spots
LE = Law Enforcement (Intelligence, Vice, OC)
Payer: Sales, Claims, Provider Relations, Legal
Hotline (Patients, Providers & Employees)
NHCAA (RIA & SIRIS)
Information Sharing (SIU, Anti-fraud Organizations, Task Force)
,⩥ -opexy.
Answer: surgical fixation
⩥ Considerations - factors to consider.
Answer: Overall strength of case
Credible witnesses
Jurisdiction or venue
Possible defenses
Amount and nature of the evidence
Circumstantial versus direct
evidence
Nature of the alleged activity
State or Federal laws
Sentencing guidelines
⩥ -oplasty.
Answer: surgical repair
⩥ burden of proof in a civil case.
Answer: preponderance of the evidence
, Means that one side has more evidence in its favor than the other, even if
by the smallest degree
Lower burden of proof
⩥ -otripsy.
Answer: crushing or destroying
⩥ Burden of proof in a criminal case.
Answer: beyond a reasonable doubt
A reasonable doubt is a doubt that would prevent a reasonable and just
Judge or jury from coming to a conclusion
Higher burden
⩥ -algia.
Answer: pain
⩥ Possible Resolutions.
Answer: Criminal Referral
Civil referral
