2025 AHIP - GENERAL COMPLIANCE ACTUAL EXAM QUESTIONS WITH CORRECT ANSWERS 100% VERIFIED GRADED A+

2025 AHIP - GENERAL COMPLIANCE
ACTUAL EXAM QUESTIONS WITH
CORRECT ANSWERS 100% VERIFIED
GRADED A+
Ansalesnagent,nemployednbynthenSponsor'snfirst-
tier,ndownstream,nornrelatednentityn(FDR),nsubmittednannapplicationnfornprocessingnandnrequested
ntwonthings:n1)ntonback-


datenthenenrollmentndatenbynonenmonth,nandn2)ntonwaivenallnmonthlynpremiumsnfornthenbeneficiar
y.nWhatnshouldnyoundo?n-
nCORRECTnANSWERSnProcessnthenapplicationnproperlyn(withoutnthenrequestednrevisions)—


informnyournsupervisornandnthencompliancenofficernaboutnthensalesnagent'snrequest



Younarenperformingnanregularninventorynofnthencontrollednsubstancesninnthenpharmacy.nYoundiscov
ernanminorninventoryndiscrepancy.nWhatnshouldnyoundo?n-
nCORRECTnANSWERSnFollownyournpharmacy'snprocedures




YounworknfornanSponsor.nLastnmonth,nwhilenreviewingnanCentersnfornMedicaren&nMedicaidnServices
n(CMS)nmonthlynreport,nyounidentifiednmultiplenindividualsnnotnenrolledninnthenplannbutnfornwhomn


thenSponsornisnpaid.nYounspokentonyournsupervisornwhonsaidndon'tnworrynaboutnit.nThisnmonth,nyou
nidentifynthensamenenrolleesnonnthenreportnagain.nWhatnshouldnyoundo?n-


nCORRECTnANSWERSnAlthoughnyounknownaboutnthenSponsor'snnon-


retaliationnpolicy,nyounarenstillnnervousnaboutnreporting—
tonbensafe,nyounsubmitnanreportnthroughnyourncompliancendepartment'snanonymousntipnlinentonav
oidnidentification



Youndiscovernannunattendednemailnaddressnornfaxnmachineninnyournofficenreceivingnbeneficiarynap
pealsnrequests.nYounsuspectnnononenisnprocessingnthenappeals.nWhatnshouldnyoundo?n-
nCORRECTnANSWERSnContactnyourncompliancendepartmentn(viancompliancenhotlinenornothernmec


hanism)