Exam (elaborations)

HCCA - CHC Study Questions/ Content covers each compliance program element, HIPAA terms, compliance related laws & regulations, study materials, and general definitions and acronyms/ 198 Q&A.

0 purchase

Course
HCCA - CHC

Institution
HCCA - CHC

[Show more]

Preview 4 out of 248 pages

View example

Uploaded on October 30, 2024
Number of pages 248
Written in 2024/2025
Type Exam (elaborations)
Contains Questions & answers

hcca chc s

Institution HCCA - CHC
Course HCCA - CHC

docmickey Member since 1 year 3932 documents sold

284

150

$19.49

Add to cart

Add to wishlist

100% satisfaction guarantee
Immediately available after payment
Both online and in PDF
No strings attached

HCCA - CHC Study Questions/ Content
covers each compliance program element,
HIPAA terms, compliance related laws &
regulations, study materials, and general
definitions and acronyms/ 198 Q&A.
Which of the following requires providers to be permanently excluded from all
federal health care programs if found guilty of a healthcare related fraud a third
time:
a. Deficit Reduction Act of 2005
b. False Claims Act
c. Balance Budget Act of 1997
d. Social Security Act section 1128 - Answer: c. Balance Budget Act of 1997

Also known as a BBA "three strikes rule"

Page 1 of 248

,Which statement is TRUE regarding compliance programs?
a. Compliance programs are considered more dangerous if they are developed but
not implemented.
b. Compliance programs can detect but not prevent criminal conduct
c. Compliance programs are only required by law for healthcare entities that have
more than $500,000 in annual revenue.
d. Compliance programs are not mandated by law. - Answer: a. Compliance
programs are considered more dangerous if they are developed but not
implemented.

Formal statement outlining a plan for a specified subject area. It usually cites state
and/or federal required actions or standards.
a. CAP
b. Procedure document
c. Policy document
d. Legal standards - Answer: c. Policy document

CAP - outlines corrective action plan
Procedure - describes process/steps under a certain criteria
Legal standards - mandatory action or rule

True or False:

Page 2 of 248

,The ACA requires that all providers adopt a compliance plan as a condition of
enrollment with Medicare, Medicaid, and Children's Health Insurance Program
(CHIP). - Answer: True

ref. ACA section 6102

According to HHS-OIG - what are three important reasons for proper
documentation in Compliance? (hint: protections) - Answer: 1. Protect our
programs
2.Protect your patients
3.Protect the Provider

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

At which level of the Medicare Part A or Part B appeals process is the appeal
decision by the Office of Medicare Hearings and Appeals (OMHA)?
a. first level of appeal
b. second level of appeal
c. third level of appeal
d. fourth level of appeal - Answer: c. . third level of appeal

Frist level - redetermination by Medicare contractor
Second level - reconsideration by Independent contractor

Page 3 of 248

, Third appeal - Administrative Law Judge (ALJ) hearing
Fourth appeal - review by Medicare Appeals Council
Fifth appeal - review in Federal District Court
https://www.hhs.gov/about/agencies/omha/the-appeals-process/index.html

What should CCO be able to do? (What skills should this person have?) Choose all
that apply.
a. Leadership skills.
b. Oversee the coding department.
c. Skills to design and implement a compliance program.
d. Be able to anticipate new risk areas.
e. Practical experience with documenting medical necessity. - Answer: a.
Leadership skills,
c. Skills to design and implement a compliance program, and
d. Be able to anticipate new risk areas.

Which of the following is an absolute necessity in order to have a successful
Compliance Program?
a. continuous training and improvements
b. effective reporting path
c. non-retaliation for whistleblowers
d. reliable and equal discipline - Answer: c. non-retaliation for whistleblowers

A Compliance Program with well written policies and procedures:
a. can be successful if consistently reviewed and maintained

Page 4 of 248

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller docmickey. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for $19.49. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

67418 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 15 years now

Start selling

Seller

Exam (elaborations) ·

Exam (elaborations)

HCCA - CHC Study Questions/ Content covers each compliance program element, HIPAA terms, compliance related laws & regulations, study materials, and general definitions and acronyms/ 198 Q&A.

Document information

Subjects

Written for