RHIT EXAM PREP PRACTICE QUESTIONS DOMAIN III (Compliance)

OASIS data are used to assess the _____ of home health services A) Outcome B) Financial performance C) Utilization D) Core measure - A)Outcome (215) A statement or guideline that directs decision making or behavior is called a: A) Directive B) Procedure C) Policy D) Process - C) Policy (216) Examples of high-risk billing practices that create compliance risks for healthcare organizations include all EXCEPT which of the following? A) Altered claim forms B) Returned overpayments C) Duplicate billings D) Unbundled procedures - B) Returned overpayments (217) Healthcare fraud is all EXCEPT which of the following? A) Unnecessary costs to a program B) False representation of fact C) Failure to disclose a material fact D) Damage to another party that reasonably relied on misrepresentation - A) Unnecessary costs to a program (218) Corporate compliance programs became common after adoption of which of the following? A) False Claims Act B) Federal Sentencing Guidelines C) Office of the Inspector General for HHS D) Federal Physician Self-Referral Statute - B) Federal Sentencing Guidelines (219) Which of the following is a legal concern regarding the EHR? A) Ability to subpoena audit trails B) Template design C) ANSI standards D) Data sets - A) Ability to subpoena audit trails (220) The act of granting approval to a healthcare organization based on whether the organization has met a set of voluntary standards is called: A) Accreditation B) Licensure C) Acceptance D) Approval - A) Accreditation (221) A group practice has hired an HIT as its chief compliance officer. The current compliance program includes written standards of conduct and policies and procedures that address specific areas of potential fraud. It also has audits in place to monitor compliance. Which of the following should the compliance officer also ensure are in place? A) Compliance program education and training programs for all employees in the organization B) A hotline to receive complaints and adoption of procedures to protect whistleblowers from retaliation C) Procedures to adequately identify individuals who make complaints so that appropriate follow-up can be conducted D) A corporate compliance committee that reports directly to the CFO - B) A hotline to receive complaints and adoption of procedures to protect whistleblowers from retaliation (222) In developing a coding compliance program, which of the following would NOT be ordinarily included as participants in coding compliance education? A) Current coding professional B) Medical Staff C) Newly hired coding personnel D) Nursing staff - D) Nursing Staff (223) Which of the following organizations within the federal government is responsible for looking at the issues related to the efficiency and effectiveness of the healthcare delivery system, disease protocols, and guidelines for improved disease outcomes? A) Agency for Healthcare Research and Quality B) Food and Drug Administration C) National Center for Health Statistics D) Centers for Medicare and Medicaid Services - A) Agency for Healthcare Research and Quality (224) Which of the following issues compliance program guidance? A) AHIMA B) CMS C) Federal Register D) HHS Office of Inspector General - D) HHS Office of Inspector General (225) Which of the following is an example of data security? A) Automatic logoff after inactivity B) Fire protection C) Contingency planning D) Card key for access to data center - A) Automatic logoff after inactivity