HCA CERTIFICATION TRAINING EXAM 2024/2025 WITH 100% ACCURATE SOLUTIONS
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Course
HCA CERTIFICATION TRAINING
Institution
HCA CERTIFICATION TRAINING
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). - Precise Answer True
According to HHS-OIG - what are three important reasons for proper documentation in Compliance?
1.Protect our...
HCA CERTIFICATION TRAINING EXAM
2024/2025 WITH 100% ACCURATE
SOLUTIONS
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). - Precise Answer ✔✔True
According to HHS-OIG - what are three important reasons for proper
documentation in Compliance?
1.Protect our ___________________
2.Protect your ___________________
3.Protect the ___________________ - Precise Answer ✔✔1.Protect our
programs
2.Protect your patients
3.Protect the Provider
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 - Precise Answer ✔✔c. third level of appeal
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. - Precise
Answer ✔✔a. Leadership skills, c. Skills to design and implement a
compliance program, and d. Be able to anticipate new risk areas.
What is the appeals process is the appeal decision by the Office of
Medicare Hearings and Appeals (OMHA)?
Frist level - _________________________
Second level - _________________________
Third appeal - _________________________
Fourth appeal - _________________________
,Fifth appeal - _________________________ - Precise Answer ✔✔Frist
level - redetermination by Medicare contractor
Second level - reconsideration by Independent contractor
Third appeal - Administrative Law Judge (ALJ) hearing
Fourth appeal - review by Medicare Appeals Council
Fifth appeal - review in Federal District Court
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 - Precise Answer ✔✔c. non-retaliation
for whistleblowers
A Compliance Program with well written policies and procedures:
a. can be successful if consistently reviewed and maintained
b. cannot be effective due to the sheer volume presented
c. will be effective if read by management
d. will not be successful without the proper oversight - Precise Answer
✔✔d. will not be successful without the proper oversight
A Compliance Officer can achieve a higher level of compliance and
ethics engagement by:
, a. ensuring leadership reads the policies
b. increasing management involvement
c. responding to compliance hotline calls
d. monitoring the code of conduct - Precise Answer ✔✔b. increasing
management involvement
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 - Precise Answer ✔✔c. Balance
Budget Act of 1997
Also known as a BBA "three strikes rule"
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.
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