https://www.stuvia.com/user/lectkeshi
HCCA - CHC EXAM STUDY PACK 2024 –ACTUAL EXAM QUESTIONS WITH 100%
VERIFIED SOLUTIONS-LATEST UPDATE 2023-2024/A+ GRADE
True or False:
The ACA requires that all providers adopt a compliance plan as a condition of
enrollment withMedicare, Medicaid, and Children's Health Insurance Program
(CHIP).
✔✔True
ref. ACA section 6102
According to HHS-OIG - what are three important reasons for proper
documentation inCompliance? (hint: protections)
✔✔1.Protect our programs
2. Protect your patients
3. Protect the Provider
At which level of the Medicare Part A or Part B appeals process is the appeal
decision by theOffice of Medicare Hearings and Appeals (OMHA)?
https://www.stuvia.com/user/lectkeshi
,https://www.stuvia.com/user/lectkeshi
a. first level of appeal
b. second level of appeal
c. third level of appeal
d. fourth level of appeal
✔✔c. . third level of appeal
Frist level - redetermination by Medicare
contractor Second level - reconsideration by
Independent contractorThird appeal -
Administrative Law Judge (ALJ) hearing Fourth
appeal - review by Medicare Appeals Council
Fifth appeal - review in Federal District Court
https://www.hhs.gov/about/agencies/omha/the-appeals-process/index.html
What should CCO be able to do? (What skills should this person have?) 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.
https://www.stuvia.com/user/lectkeshi
,https://www.stuvia.com/user/lectkeshi
e. Practical experience with documenting medical necessity.
✔✔a. Leadership skills,
https://www.stuvia.com/user/lectkeshi
, https://www.stuvia.com/user/lectkeshi
c. Skills to design and implement a compliance program, and
d. Be able to anticipate new risk areas.
Which of the following is an absolute necessity in order to have a successful
ComplianceProgram?
a. continuous training and improvements
b. effective reporting path
c. non-retaliation for whistleblowers
d. reliable and equal discipline
✔✔c. non-retaliation for whistleblowers
A Compliance Program with well written policies and procedures:
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
✔✔d. will not be successful without the
proper oversight
https://www.stuvia.com/user/lectkeshi
HCCA - CHC EXAM STUDY PACK 2024 –ACTUAL EXAM QUESTIONS WITH 100%
VERIFIED SOLUTIONS-LATEST UPDATE 2023-2024/A+ GRADE
True or False:
The ACA requires that all providers adopt a compliance plan as a condition of
enrollment withMedicare, Medicaid, and Children's Health Insurance Program
(CHIP).
✔✔True
ref. ACA section 6102
According to HHS-OIG - what are three important reasons for proper
documentation inCompliance? (hint: protections)
✔✔1.Protect our programs
2. Protect your patients
3. Protect the Provider
At which level of the Medicare Part A or Part B appeals process is the appeal
decision by theOffice of Medicare Hearings and Appeals (OMHA)?
https://www.stuvia.com/user/lectkeshi
,https://www.stuvia.com/user/lectkeshi
a. first level of appeal
b. second level of appeal
c. third level of appeal
d. fourth level of appeal
✔✔c. . third level of appeal
Frist level - redetermination by Medicare
contractor Second level - reconsideration by
Independent contractorThird appeal -
Administrative Law Judge (ALJ) hearing Fourth
appeal - review by Medicare Appeals Council
Fifth appeal - review in Federal District Court
https://www.hhs.gov/about/agencies/omha/the-appeals-process/index.html
What should CCO be able to do? (What skills should this person have?) 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.
https://www.stuvia.com/user/lectkeshi
,https://www.stuvia.com/user/lectkeshi
e. Practical experience with documenting medical necessity.
✔✔a. Leadership skills,
https://www.stuvia.com/user/lectkeshi
, https://www.stuvia.com/user/lectkeshi
c. Skills to design and implement a compliance program, and
d. Be able to anticipate new risk areas.
Which of the following is an absolute necessity in order to have a successful
ComplianceProgram?
a. continuous training and improvements
b. effective reporting path
c. non-retaliation for whistleblowers
d. reliable and equal discipline
✔✔c. non-retaliation for whistleblowers
A Compliance Program with well written policies and procedures:
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
✔✔d. will not be successful without the
proper oversight
https://www.stuvia.com/user/lectkeshi
