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HCCA - CHC (Master Flashcards)
Comprehensive Study Questions &
Answers 2026
Regarding statistical sampling, what is an example of failed efforts to use
statistical analysis?
a. Users who did not understand subject matter or application of sampling.
b. A well-rounded data sample
c. Knowledgeable staff who are involved in the process
d. Investigations done of improper billing practices - correct-answer-a. Users who
did not understand subject matter or application of sampling.
The use of qualified personnel and adequate resources is key. Use of experts,
when appropriate.
True or False:
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A hospital with an imposed-CIA performs a discovery sample as part of the Claim
Review and finds it has a financial error rate above 5%. OIG requires that the
hospital then conducts a full sample. - correct-answer-TRUE
Probe and Discovery Samples are used to get an initial glimpse and seriousness of
a problem to determine if the size of a Full Sample is needed. For example, in
Corporate Integrity Agreements (CIA) the OIG requires a Full Sample to be used, if
the overpayment error rate, or financial error rate, in a Discovery Sample is at or
above 5%.
https://oig.hhs.gov/faqs/corporate-integrity-agreements-faq.asp
https://www.americanbar.org/content/dam/aba/administrative/healthlaw/14_e
merging_trends_in_false_claims_act_damages_settlements_07.authcheckdam.p
df
True or False:
If an IRO (independent review organization) identifies any underpayments during
a CIA-Claim Review for a hospital, these may be netted (or offset) from
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overpayments. The hospital may also consult with the appropriate payor to
ensure if the underpayment amounts can be used against outstanding
overpayments. - correct-answer-TRUE
For purposes of reporting the overpayment to the OIG, underpayments may be
netted (or offset) from overpayments. However, in terms of repaying the
overpayment to the appropriate payor, the provider should consult with that
payor as to whether it will allow underpayments to be netted from overpayments
for collection purposes.
https://www.americanbar.org/content/dam/aba/administrative/healthlaw/14_e
merging_trends_in_false_claims_act_damages_settlements_07.authcheckdam.p
df
The following questions would be pertinent to every organization to help the
__________________ professional in reviewing policies and procedures that need
to be addressed:
Does the organization employ non-physician practitioners?
Does the organization perform services in a rural clinic settings?
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Does the organization provide medical services that fall under the Physicians at
Teaching Hospital (PATH) rules?
Does the organization participate in clinical trials (research)?
a. Human Resources Director
b. Chief of Hospital Operations
c. Chief of Compliance
d. Medical Staff Services - correct-answer-c. Chief of Compliance
These are common questions that help a compliance officer in reviewing some
common areas that policies and procedures may need to be addressed.
What is RAT STATS?
a. Government hotline for fraud and abuse
b. Government statistical rules (for example sample size)
c. Hospital technology for tracking sampling
d. Statistical software for hospitals to use - correct-answer-b. Government
statistical rules (for example sample size)
HCCA - CHC (Master Flashcards)
Comprehensive Study Questions &
Answers 2026
Regarding statistical sampling, what is an example of failed efforts to use
statistical analysis?
a. Users who did not understand subject matter or application of sampling.
b. A well-rounded data sample
c. Knowledgeable staff who are involved in the process
d. Investigations done of improper billing practices - correct-answer-a. Users who
did not understand subject matter or application of sampling.
The use of qualified personnel and adequate resources is key. Use of experts,
when appropriate.
True or False:
,2|Page
A hospital with an imposed-CIA performs a discovery sample as part of the Claim
Review and finds it has a financial error rate above 5%. OIG requires that the
hospital then conducts a full sample. - correct-answer-TRUE
Probe and Discovery Samples are used to get an initial glimpse and seriousness of
a problem to determine if the size of a Full Sample is needed. For example, in
Corporate Integrity Agreements (CIA) the OIG requires a Full Sample to be used, if
the overpayment error rate, or financial error rate, in a Discovery Sample is at or
above 5%.
https://oig.hhs.gov/faqs/corporate-integrity-agreements-faq.asp
https://www.americanbar.org/content/dam/aba/administrative/healthlaw/14_e
merging_trends_in_false_claims_act_damages_settlements_07.authcheckdam.p
df
True or False:
If an IRO (independent review organization) identifies any underpayments during
a CIA-Claim Review for a hospital, these may be netted (or offset) from
,3|Page
overpayments. The hospital may also consult with the appropriate payor to
ensure if the underpayment amounts can be used against outstanding
overpayments. - correct-answer-TRUE
For purposes of reporting the overpayment to the OIG, underpayments may be
netted (or offset) from overpayments. However, in terms of repaying the
overpayment to the appropriate payor, the provider should consult with that
payor as to whether it will allow underpayments to be netted from overpayments
for collection purposes.
https://www.americanbar.org/content/dam/aba/administrative/healthlaw/14_e
merging_trends_in_false_claims_act_damages_settlements_07.authcheckdam.p
df
The following questions would be pertinent to every organization to help the
__________________ professional in reviewing policies and procedures that need
to be addressed:
Does the organization employ non-physician practitioners?
Does the organization perform services in a rural clinic settings?
, 4|Page
Does the organization provide medical services that fall under the Physicians at
Teaching Hospital (PATH) rules?
Does the organization participate in clinical trials (research)?
a. Human Resources Director
b. Chief of Hospital Operations
c. Chief of Compliance
d. Medical Staff Services - correct-answer-c. Chief of Compliance
These are common questions that help a compliance officer in reviewing some
common areas that policies and procedures may need to be addressed.
What is RAT STATS?
a. Government hotline for fraud and abuse
b. Government statistical rules (for example sample size)
c. Hospital technology for tracking sampling
d. Statistical software for hospitals to use - correct-answer-b. Government
statistical rules (for example sample size)
