AHIP FRAUD WASTE & ABUSE GRADE
A+ COMPLETE EXAM QUESTIONS AND
100% VERIFIED ANSWERS (2026/2027)
PASS GUARANTEE
WhichCofCtheCfollowingCrequiresCintentCtoCobtainCpaymentCandCtheCknowledgeCthatCtheCactionsCar
eCwrong?C-CCORRECTCANSWERFraud
WhichCofCtheCfollowingCisCnotCpotentiallyCaCpenaltyCforCviolationCofCtheClawCorCregulationCprohibiti
ngCfraud,CwasteCandCabuseC(fwa)?C-CCORRECTCANSWERDeportation
ACpersonCcomesCintoCyourCpharmacyCtoCdropCoffCaCprescriptionCforCaCbeneficiaryCwhoCisCaCregularC
customer.CTheCprescriptionCisCforCaCcontrolledCsubstanceCwithCaCquantityCofC160.CThisCbeneficiaryC
normallyCreceivesCaCquantityCofC60,CnotC160.CYouCreviewCtheCprescriptionCandChaveCconcernsCabou
tCtheCpossibleCforgery.CWhatCisCyourCnextCstep?C-
CCORRECTCANSWERCallCtheCprescriberCtoCverifyCtheCquantity
YourCjobCisCtoCsubmitCriskCdiagnosisCtoCtheCcentersCforCMedicareC&CmedicaidCservicesC(cms)CforCthe
CpurposeCofCpayment.CAsCpartCofCthisCjobCyouCverify,CthroughCaCcertainCprocess,CthatCtheCdataCisCac
curate.CYourCimmediateCsupervisorCtellsCyouCtoCignoreCtheCsponsorsCprocessCandCtoCadjust/addCris
kCdiagnosisCcodesCforCcertainCindividuals.CWhatCshouldCyouCdo?C-
CCORRECTCANSWERReportCtheCincidentCtoCtheCcomplianceCdepartmentC(viaCcomplianceChotlineCo
rCotherCmechanism)
YouCareCinCchargeCofCpaymentCofCclaimsCsubmittedCbyCproviders.CYouCnoticeCaCcertainCdiagnosticCp
roviderC("doeCdiagnostics")CrequestedCaCsubstantialCpaymentCforCaClargeCnumberCofCmembers.CMa
nyCofCtheseCclaimsCareCforCcertainCprocedure.CYouCreviewCtheCsameCtypeCofCprocedureCforCotherCdi
agnosticCprovidersCandCrealizeCthatCdoeCdiagnostics'CclaimCfarCexceedCanyCotherCproviderCthatCyouC
reviewed.CWhatCshouldCyouCdo?C-
A+ COMPLETE EXAM QUESTIONS AND
100% VERIFIED ANSWERS (2026/2027)
PASS GUARANTEE
WhichCofCtheCfollowingCrequiresCintentCtoCobtainCpaymentCandCtheCknowledgeCthatCtheCactionsCar
eCwrong?C-CCORRECTCANSWERFraud
WhichCofCtheCfollowingCisCnotCpotentiallyCaCpenaltyCforCviolationCofCtheClawCorCregulationCprohibiti
ngCfraud,CwasteCandCabuseC(fwa)?C-CCORRECTCANSWERDeportation
ACpersonCcomesCintoCyourCpharmacyCtoCdropCoffCaCprescriptionCforCaCbeneficiaryCwhoCisCaCregularC
customer.CTheCprescriptionCisCforCaCcontrolledCsubstanceCwithCaCquantityCofC160.CThisCbeneficiaryC
normallyCreceivesCaCquantityCofC60,CnotC160.CYouCreviewCtheCprescriptionCandChaveCconcernsCabou
tCtheCpossibleCforgery.CWhatCisCyourCnextCstep?C-
CCORRECTCANSWERCallCtheCprescriberCtoCverifyCtheCquantity
YourCjobCisCtoCsubmitCriskCdiagnosisCtoCtheCcentersCforCMedicareC&CmedicaidCservicesC(cms)CforCthe
CpurposeCofCpayment.CAsCpartCofCthisCjobCyouCverify,CthroughCaCcertainCprocess,CthatCtheCdataCisCac
curate.CYourCimmediateCsupervisorCtellsCyouCtoCignoreCtheCsponsorsCprocessCandCtoCadjust/addCris
kCdiagnosisCcodesCforCcertainCindividuals.CWhatCshouldCyouCdo?C-
CCORRECTCANSWERReportCtheCincidentCtoCtheCcomplianceCdepartmentC(viaCcomplianceChotlineCo
rCotherCmechanism)
YouCareCinCchargeCofCpaymentCofCclaimsCsubmittedCbyCproviders.CYouCnoticeCaCcertainCdiagnosticCp
roviderC("doeCdiagnostics")CrequestedCaCsubstantialCpaymentCforCaClargeCnumberCofCmembers.CMa
nyCofCtheseCclaimsCareCforCcertainCprocedure.CYouCreviewCtheCsameCtypeCofCprocedureCforCotherCdi
agnosticCprovidersCandCrealizeCthatCdoeCdiagnostics'CclaimCfarCexceedCanyCotherCproviderCthatCyouC
reviewed.CWhatCshouldCyouCdo?C-