CHC Auditing & Monitoring (3)
UPDATED ACTUAL Exam Questions
and CORRECT Answers
Save
Terms in this set (44)
,True or False: True
The ACA
requires that all ref. ACA section 6102
providers adopt
a compliance
plan as a
condition of
enrollment with
Medicare,
Medicaid, and
Children's Health
Insurance
Program (CHIP).
,A billing 4. Analyze the details related to the
manager is increase in payments to identify
reviewing the possible sources or causes for
monthly increase in reimbursement
reimbursement
report for the
department. The
manager notices
that there is an
increase of 50%
over the
expected
amount of
incoming
payments from
Federal health
care programs
for treatment of
patients. The
manager
believes action is
needed. The
manager's NEXT
step is to:
1. Stop all
outgoing claims
, to Federal health
care programs
2. Extrapolate
the last 6 months
of
reimbursement
totals to identify
the overpayment
due to health
care programs
3. Contact legal
for next steps or
further direction
to include
advice on how
to proceed with
the self
disclosure
protocol
4. Analyze the
details related to
the increase in
payments to
identify possible
sources or
causes for
UPDATED ACTUAL Exam Questions
and CORRECT Answers
Save
Terms in this set (44)
,True or False: True
The ACA
requires that all ref. ACA section 6102
providers adopt
a compliance
plan as a
condition of
enrollment with
Medicare,
Medicaid, and
Children's Health
Insurance
Program (CHIP).
,A billing 4. Analyze the details related to the
manager is increase in payments to identify
reviewing the possible sources or causes for
monthly increase in reimbursement
reimbursement
report for the
department. The
manager notices
that there is an
increase of 50%
over the
expected
amount of
incoming
payments from
Federal health
care programs
for treatment of
patients. The
manager
believes action is
needed. The
manager's NEXT
step is to:
1. Stop all
outgoing claims
, to Federal health
care programs
2. Extrapolate
the last 6 months
of
reimbursement
totals to identify
the overpayment
due to health
care programs
3. Contact legal
for next steps or
further direction
to include
advice on how
to proceed with
the self
disclosure
protocol
4. Analyze the
details related to
the increase in
payments to
identify possible
sources or
causes for
