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CHC - CCB Practice Test Questions with Answers
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CHC - CCB Practice Test Questions with Answers
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Organizations receiving more than $5 million in Medicaid funds must provide educationon the False Claims Act (FCA) in accordance with the:
a. Stark Laws
b. Deficit Reduction Act (DRA)
c. Anti-Kickback (AKS) Law
d. Sherman Antitrust Law - Correct answer b. Deficit Reduction Act (DRA)
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?
a. Deficit Reduction Act (DRA)
b. Conditions of Participation (CoP)
c. IRS tax-exempt guidelines
d. Anti-Kickback (AKS) Safe Harbors - Correct answer d. Anti-Kickback (AKS) Safe
Harbors
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
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 c. Conduct a probe sample
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 a. 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 c. in a consistent manner
Which of the following is the BEST question to include in an employee exit interview?
a. Why are you leaving your job?
b. Did you ever observe anything that made you feel uncomfortable?
c. How many times did you use the compliance hotline?
d. Do you think your patients knew about the hotline? - Correct answer b. 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 d. patient satisfaction
A preliminary investigation identified payments to physicians for medical directorship
without written contracts. Which of the following should be the compliance professional's
NEXT step?
a. determine if Medicare payments were received
b. initiate a voluntary disclosure
c. provide education to contracting office
d. refund payments to the contractors - Correct answer a. determine if Medicare
payments were received
In an investigation, the MOST important responsibility of the compliance professional is
to
a. personally conduct all investigations
b. assure independence in investigations
c. set the scope and sample size related to investigations
d. remain within the budget for investigations - Correct answer c. set the scope and
sample size related to investigations
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