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UHC ETHICS AND COMPLIANCE EXAM (NEW UPDATED VERSION) LATEST
ACTUAL EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED QUESTIONS AND
ANSWERS) | GUARANTEED PASS A+ UPDATED THIS YEAR
UHC Ethics & Compliance Exam —
Section 1: Code of Conduct & Professionalism
1. The UHC Code of Conduct exists to:
A. Restrict employee communication
B. Provide guidelines for ethical behavior
C. Increase profits only
D. Eliminate all risks
Answer: B
Explanation: The Code of Conduct guides employees to act ethically and responsibly in
all business dealings.
2. An employee who witnesses a coworker violating company policy should:
A. Ignore it
B. Report it through proper channels
C. Email coworkers about it
D. Leave their job immediately
Answer: B
Explanation: Reporting violations promptly ensures compliance and protects the
organization.
3. Acting with integrity means:
A. Doing what is easy
B. Doing what is profitable
C. Doing what is right, even when no one is watching
D. Winning at all costs
Answer: C
Explanation: Integrity is maintaining ethical behavior even without supervision.
4. Which behavior demonstrates professionalism at UHC?
A. Consistently meeting deadlines
B. Gossiping about coworkers
C. Ignoring policies
D. Bypassing reporting requirements
Answer: A
Explanation: Professionalism includes accountability and reliability in daily work.
5. Employees are expected to:
A. Always follow policies and laws
B. Only comply when convenient
C. Ignore minor ethical issues
2026 2027 GRADED A+
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D. Rely on supervisors to act first
Answer: A
Explanation: Full compliance is required to uphold the company’s ethical standards.
Section 2: HIPAA & Privacy
6. HIPAA primarily protects:
A. Financial data only
B. Patient health information
C. Company payroll records
D. Internal emails
Answer: B
Explanation: HIPAA safeguards the confidentiality and security of protected health
information (PHI).
7. A Covered Entity under HIPAA includes:
A. Restaurants
B. Health plans
C. Clothing stores
D. Landscaping companies
Answer: B
Explanation: Health plans, healthcare providers, and healthcare clearinghouses are
Covered Entities under HIPAA.
8. If you suspect a HIPAA violation, you should:
A. Share the suspected violation with coworkers
B. Report it through UHC compliance channels
C. Post it on social media
D. Ignore it
Answer: B
Explanation: Reporting ensures that potential breaches are addressed appropriately.
9. Accessing PHI for personal reasons is:
A. Acceptable if brief
B. Always prohibited
C. Encouraged for learning
D. Allowed with verbal consent
Answer: B
Explanation: PHI must only be accessed for legitimate business purposes.
10. Leaving your workstation unlocked where PHI can be seen by others is:
A. Safe
B. A privacy violation
C. Unrelated to compliance
D. Recommended
Answer: B
Explanation: Unauthorized access to PHI is a serious compliance violation.
2026 2027 GRADED A+
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Section 3: Fraud, Waste & Abuse (FWA)
11. Fraud in healthcare most commonly involves:
A. Honest mistakes
B. Intentional deception for financial gain
C. Patient compliments
D. Routine reporting
Answer: B
Explanation: Fraud involves deliberate deception to receive unauthorized benefits.
12. Submitting a claim for services not rendered is:
A. Acceptable under certain conditions
B. Fraud
C. A compliance best practice
D. A HIPAA requirement
Answer: B
Explanation: Billing for unperformed services is considered fraudulent activity.
13. Billing a more expensive procedure than was performed is known as:
A. Upcoding
B. Downcoding
C. Auditing
D. Reporting
Answer: A
Explanation: Upcoding misrepresents services for higher reimbursement, which is
illegal.
14. Waste in healthcare refers to:
A. Intentional deception for gain
B. Overutilization or unnecessary cost
C. Efficient resource use
D. Ethical billing practices
Answer: B
Explanation: Waste involves spending more than necessary without fraudulent intent.
15. Abuse in healthcare includes:
A. Practices inconsistent with accepted standards
B. Intentional fraud
C. Following policies
D. Proper documentation
Answer: A
Explanation: Abuse is improper or excessive practices that may result in unnecessary
costs.
16. An employee discovers a coding error that resulted in overpayment. The best action is to:
A. Ignore it
B. Correct the error and report it
C. Hide it from auditors
D. Ask the patient to cover it
Answer: B
Explanation: Correcting and reporting errors ensures compliance and prevents fraud.
2026 2027 GRADED A+
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17. Falsifying medical records is:
A. Acceptable in emergencies
B. Fraud
C. Standard practice
D. Only a minor violation
Answer: B
Explanation: Altering records intentionally is illegal and unethical.
18. Upcoding can result in:
A. Legal penalties and fines
B. Rewards
C. Improved patient care
D. Faster billing
Answer: A
Explanation: Fraudulent billing exposes the organization and employee to legal action.
19. Which is an example of waste?
A. Ordering unnecessary lab tests
B. Submitting claims for services not performed
C. Falsifying patient data
D. Stealing office supplies
Answer: A
Explanation: Waste is inefficient or unnecessary use of resources, even without fraud.
20. Reporting suspected FWA is important because:
A. It reduces corporate profits
B. It maintains integrity and legal compliance
C. It increases paperwork
D. It is optional
Answer: B
Explanation: Reporting protects the company, patients, and employees from legal and
ethical risks.
Section 4: Conflicts of Interest
21. A conflict of interest occurs when:
A. Your personal interest may influence your professional judgment
B. You respectfully disagree with a coworker
C. You refuse extra work
D. You take a scheduled break
Answer: A
Explanation: Conflicts of interest can compromise decision-making or objectivity.
22. Accepting gifts from vendors that could influence purchasing decisions is:
A. Always allowed
B. A potential conflict of interest
C. Encouraged
D. Required
2026 2027 GRADED A+
UHC ETHICS AND COMPLIANCE EXAM (NEW UPDATED VERSION) LATEST
ACTUAL EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED QUESTIONS AND
ANSWERS) | GUARANTEED PASS A+ UPDATED THIS YEAR
UHC Ethics & Compliance Exam —
Section 1: Code of Conduct & Professionalism
1. The UHC Code of Conduct exists to:
A. Restrict employee communication
B. Provide guidelines for ethical behavior
C. Increase profits only
D. Eliminate all risks
Answer: B
Explanation: The Code of Conduct guides employees to act ethically and responsibly in
all business dealings.
2. An employee who witnesses a coworker violating company policy should:
A. Ignore it
B. Report it through proper channels
C. Email coworkers about it
D. Leave their job immediately
Answer: B
Explanation: Reporting violations promptly ensures compliance and protects the
organization.
3. Acting with integrity means:
A. Doing what is easy
B. Doing what is profitable
C. Doing what is right, even when no one is watching
D. Winning at all costs
Answer: C
Explanation: Integrity is maintaining ethical behavior even without supervision.
4. Which behavior demonstrates professionalism at UHC?
A. Consistently meeting deadlines
B. Gossiping about coworkers
C. Ignoring policies
D. Bypassing reporting requirements
Answer: A
Explanation: Professionalism includes accountability and reliability in daily work.
5. Employees are expected to:
A. Always follow policies and laws
B. Only comply when convenient
C. Ignore minor ethical issues
2026 2027 GRADED A+
,2|Page
D. Rely on supervisors to act first
Answer: A
Explanation: Full compliance is required to uphold the company’s ethical standards.
Section 2: HIPAA & Privacy
6. HIPAA primarily protects:
A. Financial data only
B. Patient health information
C. Company payroll records
D. Internal emails
Answer: B
Explanation: HIPAA safeguards the confidentiality and security of protected health
information (PHI).
7. A Covered Entity under HIPAA includes:
A. Restaurants
B. Health plans
C. Clothing stores
D. Landscaping companies
Answer: B
Explanation: Health plans, healthcare providers, and healthcare clearinghouses are
Covered Entities under HIPAA.
8. If you suspect a HIPAA violation, you should:
A. Share the suspected violation with coworkers
B. Report it through UHC compliance channels
C. Post it on social media
D. Ignore it
Answer: B
Explanation: Reporting ensures that potential breaches are addressed appropriately.
9. Accessing PHI for personal reasons is:
A. Acceptable if brief
B. Always prohibited
C. Encouraged for learning
D. Allowed with verbal consent
Answer: B
Explanation: PHI must only be accessed for legitimate business purposes.
10. Leaving your workstation unlocked where PHI can be seen by others is:
A. Safe
B. A privacy violation
C. Unrelated to compliance
D. Recommended
Answer: B
Explanation: Unauthorized access to PHI is a serious compliance violation.
2026 2027 GRADED A+
,3|Page
Section 3: Fraud, Waste & Abuse (FWA)
11. Fraud in healthcare most commonly involves:
A. Honest mistakes
B. Intentional deception for financial gain
C. Patient compliments
D. Routine reporting
Answer: B
Explanation: Fraud involves deliberate deception to receive unauthorized benefits.
12. Submitting a claim for services not rendered is:
A. Acceptable under certain conditions
B. Fraud
C. A compliance best practice
D. A HIPAA requirement
Answer: B
Explanation: Billing for unperformed services is considered fraudulent activity.
13. Billing a more expensive procedure than was performed is known as:
A. Upcoding
B. Downcoding
C. Auditing
D. Reporting
Answer: A
Explanation: Upcoding misrepresents services for higher reimbursement, which is
illegal.
14. Waste in healthcare refers to:
A. Intentional deception for gain
B. Overutilization or unnecessary cost
C. Efficient resource use
D. Ethical billing practices
Answer: B
Explanation: Waste involves spending more than necessary without fraudulent intent.
15. Abuse in healthcare includes:
A. Practices inconsistent with accepted standards
B. Intentional fraud
C. Following policies
D. Proper documentation
Answer: A
Explanation: Abuse is improper or excessive practices that may result in unnecessary
costs.
16. An employee discovers a coding error that resulted in overpayment. The best action is to:
A. Ignore it
B. Correct the error and report it
C. Hide it from auditors
D. Ask the patient to cover it
Answer: B
Explanation: Correcting and reporting errors ensures compliance and prevents fraud.
2026 2027 GRADED A+
, 4|Page
17. Falsifying medical records is:
A. Acceptable in emergencies
B. Fraud
C. Standard practice
D. Only a minor violation
Answer: B
Explanation: Altering records intentionally is illegal and unethical.
18. Upcoding can result in:
A. Legal penalties and fines
B. Rewards
C. Improved patient care
D. Faster billing
Answer: A
Explanation: Fraudulent billing exposes the organization and employee to legal action.
19. Which is an example of waste?
A. Ordering unnecessary lab tests
B. Submitting claims for services not performed
C. Falsifying patient data
D. Stealing office supplies
Answer: A
Explanation: Waste is inefficient or unnecessary use of resources, even without fraud.
20. Reporting suspected FWA is important because:
A. It reduces corporate profits
B. It maintains integrity and legal compliance
C. It increases paperwork
D. It is optional
Answer: B
Explanation: Reporting protects the company, patients, and employees from legal and
ethical risks.
Section 4: Conflicts of Interest
21. A conflict of interest occurs when:
A. Your personal interest may influence your professional judgment
B. You respectfully disagree with a coworker
C. You refuse extra work
D. You take a scheduled break
Answer: A
Explanation: Conflicts of interest can compromise decision-making or objectivity.
22. Accepting gifts from vendors that could influence purchasing decisions is:
A. Always allowed
B. A potential conflict of interest
C. Encouraged
D. Required
2026 2027 GRADED A+
