QUESTIONS AND ANSWERS
A biller at a healthcare organization realizes that there was an overpayment on a claim.
How soon must the overpayment be refunded in order to avoid further action?
a. Within 60 days of identifying the overpayment with a lookback period of 6 years
b. Within 90 days of identifying the overpayment with a lookback period of 5 years
c. Within 30 days of identifying the overpayment with a lookback period of 5 years
d. Within 120 days of identifying the overpayment with a lookback period of 6 years
- ANSWER-A. Within 60 days of identifying the overpayment with a lookback period
of 6 years
A billing department is entering charges for a dental procedure. Which type of
Healthcare Common Procedure Coding System (HCPCS) code should be used in this
situation?
a. D codes
b. L codes
c. P codes
d. E codes
- ANSWER-A. D codes
A business associate who discovers a HIPAA breach must notify the healthcare
organization no later than__________ days after its discovery:
,a. 30
b. 60
c. 90
d. 120
- ANSWER-B. 60
A CEO has suggested that the organization he oversees should purchase insurance from
a particular insurance company. It is later discovered the CEO's spouse is a board
member of the suggested insurance company. What type of policy should an
organization have in place to best address this situation?
a. Gift policy
b. Conflict of interest policy
c. Compliance policy
d. Workforce clearance policy
- ANSWER-B. Conflict of interest policy
A compliance professional is responsible for advocating for compliance resources
throughout the organization. A critical step in this process includes:
a. collecting data to demonstrate the need to senior leadership
b. developing a fundraising event to meet budgeting needs for the compliance
department
c. conducting research to support requirements by determining resources available for
larger organizations
d. articulating higher priorities to the organization that have received resources
- ANSWER-A. Collecting data to demonstrate the need to senior leadership
A compliance professional is reviewing an analysis provided by an analyst. The results
indicate that there is a 97% chance that the sample represents the population and that
the results can be replicated. What is the associated alpha level?
,a. 0.03
b. 0.05
c. 0.10
d. 0.15
- ANSWER-A. 0.03
A compliance professional is sharing information about regulatory changes with all
staff members. In order to ensure that the detailed information is appropriately
interpreted, the compliance professional invites team members to role-play different
scenarios. When referencing the three Cs of communication, this strategy aligns best
with which component?
a. concise
b. clear
c. creative
d. contextual
- ANSWER-C. Creative
A compliance professional is visiting one of the hospital's locations to interview
employees and inquire about their daily activities, as well as the policy and procedure
within their department. This is an example of:
a. monitoring
b. data collection
c. a concurrent audit
d. collaboration
- ANSWER-A. Monitoring
A compliance professional that has obtained the Certified in Healthcare Compliance
certification must renew it every 2 years. How many continuing education units (CEUs)
are required for recertification?
, a. 20 hours
b. 30 hours
c. 40 hours
d. 50 hours
- ANSWER-C. 40 hours
A full-time employee has requested time off under the Family and Medical Leave Act to
care for a sick spouse. How much job-protected time must the employee be granted
within a 12-month period?
a. 4 weeks
b. 8 weeks
c. 12 weeks
d. 16 weeks
- ANSWER-C. 12 weeks
A healthcare organization has been cyberhacked by an external party attempting to
access PHI. This type of security failure is know as:
a. system penetration
b. destruction/sabotage
c. mistakes/error
d. device compromise
- ANSWER-A. System penetration
A healthcare organization has been struggling to effectively monitor a newly developed
compliance program. Leadership has decided to conduct an external search to solicit
additional help regarding advice on applicable regulations, monitoring methods, and
reporting. Which one of the following is best positioned to support the organization
during this process?
a. Subject matter export