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Exam Updated Questions and Verified Answers, 100- Guarantee Pass

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2025 AHIP - FRAUD, WASTE, AND ABUSE EXAM
UPDATED QUESTIONS AND VERIFIED ANSWERS,
100% GUARANTEE PASS

WhichBofBtheBfollowingBrequiresBintentBtoBobtainBpaymentBandBtheBknowledgeBtheBactionsBareBwrong?B-
BcorrectBanswer-Fraud

YourBjobBisBtoBsubmitBaBriskBdiagnosisBtoBtheBCentersBforBMedicareB&BMedicaidBServicesB(CMS)BforBtheBpur
poseBofBpayment.BAsBpartBofBthisBjob,ByouBuseBaBprocessBtoBverifyBtheBdataBisBaccurate.BYourBimmediateBsu
pervisorBtellsByouBtoBignoreBtheBSponsor'sBprocessBandBtoBadjustBorBaddBriskBdiagnosisBcodesBforBcertainBin
dividuals.BWhatBshouldByouBdo?B-BcorrectBanswer-
ReportBtheBincidentBtoBtheBcomplianceBdepartmentB(viaBcomplianceBhotlineBorBotherBmechanism)

WhichBofBtheBfollowingBisBNOTBpotentiallyBaBpenaltyBforBviolationBofBaBlawBorBregulationBprohibitingBfraud,B
waste,BandBabuseB(FWA)?B-BcorrectBanswer-Deportation

YouBareBperformingBaBregularBinventoryBofBtheBcontrolledBsubstancesBinBtheBpharmacy.BYouBdiscoverBaBmin
orBinventoryBdiscrepancy.BWhatBshouldByouBdo?B-BcorrectBanswer-FollowByourBpharmacy'sBprocedures.

ABpersonBdropsBoffBaBprescriptionBforBaBbeneficiaryBwhoBisBaB"regular"Bcustomer.BTheBprescriptionBisBforBaB
controlledBsubstanceBwithBaBquantityBofB160.BThisBbeneficiaryBnormallyBreceivesBaBquantityBofB60,BnotB160
.BYouBreviewBtheBprescriptionBandBhaveBconcernsBaboutBpossibleBforgery.BWhatBisByourBnextBstep?B-
BcorrectBanswer-CallBtheBprescriberBtoBverifyBtheBquantity

YouBareBinBchargeBofBpayingBclaimsBsubmittedBbyBproviders.BYouBnoticeBaBcertainBdiagnosticBproviderB("Do
eBDiagnostics")BrequestedBaBsubstantialBpaymentBforBaBlargeBpatientBgroup.BManyBofBtheseBclaimsBareBforB
aBcertainBprocedure.BYouBreviewBtheBsameBtypeBofBprocedureBforBotherBdiagnosticBprovidersBandBrealizeBD
oeBDiagnostics'BclaimsBfarBexceedBanyBotherBproviderByouBreviewed.BWhatBshouldByouBdo?B-
BcorrectBanswer-

ConsultBwithByourBimmediateBsupervisorBforBnextBstepsBorBcontactBtheBcomplianceBdepartmentB(viaBcomp
lianceBhotline,BSpecialBInvestigationsBUnitB[SIU],BorBotherBmechanism)

BribesBorBkickbacksBofBanyBkindBforBservicesBthatBareBpaidBunderBaBFederalBhealthBcareBprogramB(whichBinc
ludesBMedicare)BconstituteBfraudBbyBtheBpersonBmakingBasBwellBasBtheBpersonBreceivingBthem.B-
BcorrectBanswer-True

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