CHPC Practice Exam Test Questions
2024/2025 With 100% Correct And Verified
Answers
Organizations receiving more than $5 million in
Medicaid funds must provide education on the
False Claims Act in accordance with the _______.
Deficit Reduction Act
Corporate integrity agreements are negotiated
primarily between the
OIG and the health care entity
A hotline caller states the coding department was
instructed to code based on LCD requirements
regardless of medical record information. Which of
the following should be the compliance
professional's FIRST action?
a. direct the coding supervisor to follow the
applicable policy
b. incorporate the coding issue into next year's risk
assessment
c. design a review to find facts and circumstances
related to the compliant
d. engage outside counsel to protect the underlying
facts from discovery
C- Design a review to find facts and circumstances
related to the compliant
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,A compliance professional identified an issue with
medical necessity. The compliance professional
should collaborate with the:
a. case manager
b. billing clerk
c. documentation specialist
d. patient account representative
case manager
When non-compliance is substantiated, disciplinary
action should be administered
a. within 30 days
b. if intent is proven
c. in a consistent manner
d. after completion of corrective action
in a consistent manner
In development of the annual work plan, physician
contract compliance was prioritized as a high-risk
area. When the compliance professional followed
up with management, it appeared that the
monitoring identified for this area was never put
into place. Which of the following should be the
compliance professional's FIRST step?
a. Develop a corrective action plan
b. Identify a statistically valid sample
c. Conduct a probe sample
d. Notify legal counsel
Conduct a probe sample
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, Which of the following is the BEST question to
include in an employee exit interview?
Did you ever observe anything that made you feel
uncomfortable?
A compliance professional is conducting a policy
review. Which of the following procedures MUST be
included in the policy for statistically valid
sampling and extrapolation?
a. financial error rate exceeds 5% with a refund to
occur within 60 days
b. financial error rate exceeds 5% with a refund to
occur within 90 days
c. coding error rate exceeds 5% with a refund to
occur within 60 days
d. coding error rate exceeds 5% with a refund to
occur within 90 days
A) financial error rate exceeds 5% with a refund to
occur within 60 days
Incentive programs based on employee
performance may be tied to increases in
a. the case mix index
b. CPT/DRG codes
c. patient referrals
d. patient satisfaction
patient satisfaction
A preliminary investigation identified payments to
physicians for medical directorships without
iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii Vendarsol
2024/2025 With 100% Correct And Verified
Answers
Organizations receiving more than $5 million in
Medicaid funds must provide education on the
False Claims Act in accordance with the _______.
Deficit Reduction Act
Corporate integrity agreements are negotiated
primarily between the
OIG and the health care entity
A hotline caller states the coding department was
instructed to code based on LCD requirements
regardless of medical record information. Which of
the following should be the compliance
professional's FIRST action?
a. direct the coding supervisor to follow the
applicable policy
b. incorporate the coding issue into next year's risk
assessment
c. design a review to find facts and circumstances
related to the compliant
d. engage outside counsel to protect the underlying
facts from discovery
C- Design a review to find facts and circumstances
related to the compliant
iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii Vendarsol
,A compliance professional identified an issue with
medical necessity. The compliance professional
should collaborate with the:
a. case manager
b. billing clerk
c. documentation specialist
d. patient account representative
case manager
When non-compliance is substantiated, disciplinary
action should be administered
a. within 30 days
b. if intent is proven
c. in a consistent manner
d. after completion of corrective action
in a consistent manner
In development of the annual work plan, physician
contract compliance was prioritized as a high-risk
area. When the compliance professional followed
up with management, it appeared that the
monitoring identified for this area was never put
into place. Which of the following should be the
compliance professional's FIRST step?
a. Develop a corrective action plan
b. Identify a statistically valid sample
c. Conduct a probe sample
d. Notify legal counsel
Conduct a probe sample
iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii Vendarsol
, Which of the following is the BEST question to
include in an employee exit interview?
Did you ever observe anything that made you feel
uncomfortable?
A compliance professional is conducting a policy
review. Which of the following procedures MUST be
included in the policy for statistically valid
sampling and extrapolation?
a. financial error rate exceeds 5% with a refund to
occur within 60 days
b. financial error rate exceeds 5% with a refund to
occur within 90 days
c. coding error rate exceeds 5% with a refund to
occur within 60 days
d. coding error rate exceeds 5% with a refund to
occur within 90 days
A) financial error rate exceeds 5% with a refund to
occur within 60 days
Incentive programs based on employee
performance may be tied to increases in
a. the case mix index
b. CPT/DRG codes
c. patient referrals
d. patient satisfaction
patient satisfaction
A preliminary investigation identified payments to
physicians for medical directorships without
iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii Vendarsol
