©PREP4EXAMS@2024[REAL EXAM DUMPS] Thursday, July 25, 2024 6:51 PM
Practice Questions for RHIT Exam: DOMAIN 5:
Compliance Questions and Answers (100% Pass)
The evaluation of coders is recommended at least quarterly for the purpose of
measurement and assurance of:
A. Speed
B. Data quality and integrity
C. Accuracy
D. Effective relationships with physicians and facility personnel - ✔️✔️Data quality
and integrity
Coders should be evaluated at least quarterly, with appropriate training needs
identified, facilitated, and reassessed over time. Only through this continuous
process of evaluation can data quality and integrity be accurately measured and
ensured.
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 - ✔️✔️Ability to subpoena audit trails
1
, ©PREP4EXAMS@2024[REAL EXAM DUMPS] Thursday, July 25, 2024 6:51 PM
There are a number of legal issues facing the electronic health record (EHR). State
laws vary as to what is and is not acceptable in a court of law regarding EHRs.
Healthcare providers frequently receive subpoenas requesting the production of the
health record. The subpoenas may require the production of audit trails.
Healthcare fraud is all except which of the following?
A. Damage to another party that reasonably relied on misrepresentation
B. False representation of fact
C. Failure to disclose a material fact
D. Unnecessary costs to a program - ✔️✔️Unnecessary costs to a program
Healthcare fraud is the intentional deception or misrepresentation that an
individual knows (or should know) to be false, or does not believe to be true, and
makes, knowing the deception could result in some unauthorized benefit to himself
or some other person(s). Unnecessary costs to a program, in and of itself, would not
be healthcare fraud, there would need to be some intentional deception for it to be
considered fraud.
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
2
, ©PREP4EXAMS@2024[REAL EXAM DUMPS] Thursday, July 25, 2024 6:51 PM
D. Federal Physician Self-Referral Statute - ✔️✔️Federal Sentencing Guidelines
The U.S. Federal Sentencing Guidelines outline seven steps as the hallmark of an
effective program to prevent and detect violations of law. These seven steps were
the basis for the OIG's recommendations regarding the fundamental elements of an
effective compliance program.
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. A bonus program for coders who code charts with higher paying MS-DRGs
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 CFO - ✔️✔️A hotline to
receive complaints and adoption of procedures to protect whistleblowers from
retaliation
The OIG has outlined seven elements as the minimum necessary for a
comprehensive compliance program. One of the seven elements is the maintenance
of a process, such as a hotline, to receive complaints and the adoption of procedures
to protect the anonymity of complaints and to protect whistleblowers from
retaliation.
3
, ©PREP4EXAMS@2024[REAL EXAM DUMPS] Thursday, July 25, 2024 6:51 PM
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 - ✔️✔️Returned overpayments
Fraudulent billing practices represent a major compliance risk for healthcare
organizations. High-risk billing practices include: billing for noncovered services,
altered claim forms, duplicate billing, misrepresentation of facts on a claim form,
failing to return overpayments, unbundling, billing for medically unnecessary
services, overcoding and upcoding, billing for items or services not rendered, and
false cost reports.
Which of the following issues compliance program guidance?
A. AHIMA
B. CMS
C. Federal Register
D. HHS Office of Inspector General - ✔️✔️HHS Office of Inspector General
From February 1998 until the present, the Office of Inspector General (OIG)
continues to issue compliance program guidance for various types of healthcare
4
Practice Questions for RHIT Exam: DOMAIN 5:
Compliance Questions and Answers (100% Pass)
The evaluation of coders is recommended at least quarterly for the purpose of
measurement and assurance of:
A. Speed
B. Data quality and integrity
C. Accuracy
D. Effective relationships with physicians and facility personnel - ✔️✔️Data quality
and integrity
Coders should be evaluated at least quarterly, with appropriate training needs
identified, facilitated, and reassessed over time. Only through this continuous
process of evaluation can data quality and integrity be accurately measured and
ensured.
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 - ✔️✔️Ability to subpoena audit trails
1
, ©PREP4EXAMS@2024[REAL EXAM DUMPS] Thursday, July 25, 2024 6:51 PM
There are a number of legal issues facing the electronic health record (EHR). State
laws vary as to what is and is not acceptable in a court of law regarding EHRs.
Healthcare providers frequently receive subpoenas requesting the production of the
health record. The subpoenas may require the production of audit trails.
Healthcare fraud is all except which of the following?
A. Damage to another party that reasonably relied on misrepresentation
B. False representation of fact
C. Failure to disclose a material fact
D. Unnecessary costs to a program - ✔️✔️Unnecessary costs to a program
Healthcare fraud is the intentional deception or misrepresentation that an
individual knows (or should know) to be false, or does not believe to be true, and
makes, knowing the deception could result in some unauthorized benefit to himself
or some other person(s). Unnecessary costs to a program, in and of itself, would not
be healthcare fraud, there would need to be some intentional deception for it to be
considered fraud.
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
2
, ©PREP4EXAMS@2024[REAL EXAM DUMPS] Thursday, July 25, 2024 6:51 PM
D. Federal Physician Self-Referral Statute - ✔️✔️Federal Sentencing Guidelines
The U.S. Federal Sentencing Guidelines outline seven steps as the hallmark of an
effective program to prevent and detect violations of law. These seven steps were
the basis for the OIG's recommendations regarding the fundamental elements of an
effective compliance program.
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. A bonus program for coders who code charts with higher paying MS-DRGs
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 CFO - ✔️✔️A hotline to
receive complaints and adoption of procedures to protect whistleblowers from
retaliation
The OIG has outlined seven elements as the minimum necessary for a
comprehensive compliance program. One of the seven elements is the maintenance
of a process, such as a hotline, to receive complaints and the adoption of procedures
to protect the anonymity of complaints and to protect whistleblowers from
retaliation.
3
, ©PREP4EXAMS@2024[REAL EXAM DUMPS] Thursday, July 25, 2024 6:51 PM
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 - ✔️✔️Returned overpayments
Fraudulent billing practices represent a major compliance risk for healthcare
organizations. High-risk billing practices include: billing for noncovered services,
altered claim forms, duplicate billing, misrepresentation of facts on a claim form,
failing to return overpayments, unbundling, billing for medically unnecessary
services, overcoding and upcoding, billing for items or services not rendered, and
false cost reports.
Which of the following issues compliance program guidance?
A. AHIMA
B. CMS
C. Federal Register
D. HHS Office of Inspector General - ✔️✔️HHS Office of Inspector General
From February 1998 until the present, the Office of Inspector General (OIG)
continues to issue compliance program guidance for various types of healthcare
4
