HCCA - CHC STUDY QUESTIONS (MASTER FLASHCARDS) AND ANSWERS RATED A+

HCCA - CHC STUDY QUESTIONS
(MASTER FLASHCARDS) AND
ANSWERS RATED A+ 2025-2026


TruedordFalse:

ThedACAdrequiresdthatdalldprovidersdadoptdadcompliancedplandasdadconditiondofdenrollmentdwithdMedicare
,dMedicaid,danddChildren'sdHealthdInsurancedProgramd(CHIP).d-dCORRECTdANSWERTrue



ref.dACAdsectiond6102



AccordingdtodHHS-OIGd-
dwhatdaredthreedimportantdreasonsdfordproperddocumentationdindCompliance?d(hint:dprotections)d-

dCORRECTdANSWER1.Protectdourdprograms



2.Protectdyourdpatients

3.ProtectdthedProvider



https://oig.hhs.gov/newsroom/podcasts/2011/heat/heat09-
trans.asp#:~:text=Proper%20documentation%2C%20both%20in%20patients,to%20protect%20you%20t
he%20provider.



AtdwhichdleveldofdthedMedicaredPartdAdordPartdBdappealsdprocessdisdthedappealddecisiondbydthedOfficedofdM
edicaredHearingsdanddAppealsd(OMHA)?

a.dfirstdleveldofdappeal

b.dseconddleveldofdappeal

c.dthirddleveldofdappeal

d.dfourthdleveldofdappeald-dCORRECTdANSWERc.d.dthirddleveldofdappeal

,Fristdleveld-dredeterminationdbydMedicaredcontractor

Seconddleveld-dreconsiderationdbydIndependentdcontractor

Thirddappeald-dAdministrativedLawdJudged(ALJ)dhearing

Fourthdappeald-dreviewdbydMedicaredAppealsdCouncil

Fifthdappeald-dreviewdindFederaldDistrictdCourt

https://www.hhs.gov/about/agencies/omha/the-appeals-process/index.html



WhatdshoulddCCOdbedabledtoddo?d(Whatdskillsdshoulddthisdpersondhave?)dChoosedalldthatdapply.

a.dLeadershipdskills.

b.dOverseedthedcodingddepartment.

c.dSkillsdtoddesigndanddimplementdadcompliancedprogram.

d.dBedabledtodanticipatednewdriskdareas.

e.dPracticaldexperiencedwithddocumentingdmedicaldnecessity.d-dCORRECTdANSWERa.dLeadershipdskills,

c.dSkillsdtoddesigndanddimplementdadcompliancedprogram,dand

d.dBedabledtodanticipatednewdriskdareas.



WhichdofdthedfollowingdisdandabsolutednecessitydindorderdtodhavedadsuccessfuldCompliancedProgram?

a.dcontinuousdtrainingdanddimprovements

b.deffectivedreportingdpath

c.dnon-retaliationdfordwhistleblowers

d.dreliabledanddequalddisciplined-dCORRECTdANSWERc.dnon-retaliationdfordwhistleblowers



AdCompliancedProgramdwithdwelldwrittendpoliciesdanddprocedures:

a.dcandbedsuccessfuldifdconsistentlydrevieweddanddmaintained

b.dcannotdbedeffectivedduedtodthedsheerdvolumedpresented

c.dwilldbedeffectivedifdreaddbydmanagement

d.dwilldnotdbedsuccessfuldwithoutdthedproperdoversightd-
dCORRECTdANSWERd.dwilldnotdbedsuccessfuldwithoutdthedproperdoversight

,Regardlessdofdhavingdthedbestdwrittendpoliciesdindplacedthatdaredreviewed/maintaineddconsistently,danddr
eaddandddisseminateddaccordingly,dwilldfaildifdtheredisdnodproperdoversightdtodensuredtheydaredactuallydbei
ngdfolloweddanddunderstood.



AdCompliancedOfficerdcandachievedadhigherdleveldofdcompliancedanddethicsdengagementdby:

a.densuringdleadershipdreadsdthedpolicies

b.dincreasingdmanagementdinvolvement

c.drespondingdtodcompliancedhotlinedcalls

d.dmonitoringdthedcodedofdconductd-dCORRECTdANSWERb.dincreasingdmanagementdinvolvement.



Compliancedisdeveryone'sdresponsibility,dbutdmanagementdinvolvementdisdcrucial.dTheydhavedaddirectdcon
tactdwithdemployees,dtheydknowdanddunderstanddtheirdstaff'sdneedsdanddconcerns,danddhavedthedmostdinfl
uencedoverdemployee'sdactionsdanddattitudes.dEmployeesdmostdlikelydusedtheirddirectdmanager(s)dtodraised
concernsdanddthedreasondtheydaredsodcriticaldfordandorganizationdtodfosterdadculturedofdcompliance.



Whichdofdthedfollowingdrequiresdprovidersdtodbedpermanentlydexcludeddfromdalldfederaldhealthdcaredprogr
amsdifdfounddguiltydofdadhealthcaredrelateddfrauddadthirddtime:

a.dDeficitdReductiondActdofd2005

b.dFalsedClaimsdAct

c.dBalancedBudgetdActdofd1997

d.dSocialdSecuritydActdsectiond1128dd-dCORRECTdANSWERc.dBalancedBudgetdActdofd1997



AlsodknowndasdadBBAd"threedstrikesdrule"



WhatdsectiondofdthedACAdpreventsddiscriminationdagainstdindividualsdwithdlimiteddEnglishdproficiencyd(LEP
),danddalsodprohibitsddiscriminationdindhealthcaredprogramsdanddactivitiesdthatdreceivedfederaldfunding,dba
seddondrace,dcolor,dnationaldorigin,dsex,dage,dorddisability.

a.dACAdsectiond6102

b.dACAdsectiond1557

c.dACAdsectiond6002d-dCORRECTdANSWERb.dACAdsectiond1557disdthedcorrectdanswer.

, a.dACAdsectiond6102drequiresdowners,doperators,danddadministratorsdofdLTCdfacilitiesdtodadoptdeffectivedc
ompliance.

c.dACAdsectiond6002drequiresdthedestablishmentdofdadtransparencydprogram,dnowdknowndasdCMSdOpendPa
yments.



WhichdstatementdisdTRUEdregardingdcompliancedprograms?

a.dCompliancedprogramsdaredconsidereddmoreddangerousdifdtheydareddevelopeddbutdnotdimplemented.

b.dCompliancedprogramsdcanddetectdbutdnotdpreventdcriminaldconduct

c.dCompliancedprogramsdaredonlydrequireddbydlawdfordhealthcaredentitiesdthatdhavedmoredthand$500,000di
ndannualdrevenue.

d.dCompliancedprogramsdarednotdmandateddbydlaw.d-
dCORRECTdANSWERa.dCompliancedprogramsdaredconsidereddmoreddangerousdifdtheydareddevelopeddbutdn

otdimplemented.



Andindividual'sdunderstandingdofdthedcompliancedaspectsdofdtheirdjobdcandBESTdbedenhanceddbydincludingd
compliancedin:

a.dannualdevaluations

b.dexitdinterviews

c.dHRdbenefitdmaterials

d.dauditdcommitteedmeetingsd-dCORRECTdANSWERa.dannualdevaluations



Formaldstatementdoutliningdadplandfordadspecifieddsubjectdarea.dItdusuallydcitesdstatedand/ordfederaldrequir
eddactionsdordstandards.

a.dCAP

b.dProcedureddocument

c.dPolicyddocument

d.dLegaldstandardsd-dCORRECTdANSWERc.dPolicyddocument



CAPd-doutlinesdcorrectivedactiondplan

Procedured-ddescribesdprocess/stepsdunderdadcertaindcriteria

Legaldstandardsd-dmandatorydactiondordrule