CHPC Practice Test - Questions With Accurate
Solutions
Organizations receiving more than $5 million in Medicaid funds
must provide education on the False Claims Act in accordance with
the _______. Correct Answer - Deficit Reduction Act
Corporate integrity agreements are negotiated primarily between
the Correct Answer - 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 Correct Answer - C- Design a review to find facts and
circumstances related to the compliant
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 Correct Answer - 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 Correct Answer - 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 Correct Answer - Conduct a probe
sample
Which of the following is the BEST question to include in an
employee exit interview? Correct Answer - 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 Correct Answer - 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 Correct Answer - patient satisfaction
A preliminary investigation identified payments to physicians for
medical directorships without written contracts. Which of the
following should be the compliance professionals NEXT step?
Correct Answer - Determine if medicare payments were received
An organization identifies a potential issue when reviewing personal
services and management contracts. Which of the following should
the compliance professional consider in analyzing the issue?
Correct Answer - Anti-Kickback Safe harbors
In an investigation, the MOST important responsibility of the
compliance professional is to Correct Answer - assure
independence in all investigations
A compliance professional discovers non-compliance with a
regulation. Which of the following should the compliance
professional do FIRST? Correct Answer - Conduct a baseline
audit
A record retention policy must be based on Correct Answer -
applicable state laws
Training is scheduled for employees to learn about cost reporting
risks. This type of training is an example of
a. online training
b. general training
c. focused training
Solutions
Organizations receiving more than $5 million in Medicaid funds
must provide education on the False Claims Act in accordance with
the _______. Correct Answer - Deficit Reduction Act
Corporate integrity agreements are negotiated primarily between
the Correct Answer - 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 Correct Answer - C- Design a review to find facts and
circumstances related to the compliant
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 Correct Answer - 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 Correct Answer - 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 Correct Answer - Conduct a probe
sample
Which of the following is the BEST question to include in an
employee exit interview? Correct Answer - 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 Correct Answer - 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 Correct Answer - patient satisfaction
A preliminary investigation identified payments to physicians for
medical directorships without written contracts. Which of the
following should be the compliance professionals NEXT step?
Correct Answer - Determine if medicare payments were received
An organization identifies a potential issue when reviewing personal
services and management contracts. Which of the following should
the compliance professional consider in analyzing the issue?
Correct Answer - Anti-Kickback Safe harbors
In an investigation, the MOST important responsibility of the
compliance professional is to Correct Answer - assure
independence in all investigations
A compliance professional discovers non-compliance with a
regulation. Which of the following should the compliance
professional do FIRST? Correct Answer - Conduct a baseline
audit
A record retention policy must be based on Correct Answer -
applicable state laws
Training is scheduled for employees to learn about cost reporting
risks. This type of training is an example of
a. online training
b. general training
c. focused training
