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CHPC EXAM STUDY SET 2,WITH COMPLETE ANSWERS.
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CHPC EXAM STUDY SET 2,WITH COMPLETE ANSWERS.
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CHPC EXAM STUDY SET2,WITH COMPLETE
ANSWERS
c
1.Organizations receiving more than $5 million in Medicaid funds must pro-
vide education on the False Claims Act in accordance with the .:
Deficit Reduction Act
2.Corporate integrity agreements are negotiated primarily between the:
OIG and the health care entity
3.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:
C- Design a review to find facts and circumstances related to the
compliant
4.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: case manager
5.When non-compliance is substantiated, disciplinary action should be
ad- ministered
a. within 30 days
b. if intent is proven
c. in a consistent manner
d. after completion of corrective action: in a consistent manner
6.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: Conduct a probe sample
7.Which of the following is the BEST question to include in an employee
exit interview?: Did you ever observe anything that made you feel
uncomfortable?
8.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:
A) financial error rate exceeds 5% with a refund to occur within 60
days
9.Incentive programs based on employee performance may be tied to
increas- es in
a. the case mix index
b. CPT/DRG codes
c. patient referrals
d. patient satisfaction: patient satisfaction
10.A preliminary investigation identified payments to physicians for
medical directorships without written contracts. Which of the following
should be the compliance professionals NEXT step?: Determine if
medicare payments were received
11.An organization identifies a potential issue when reviewing personal ser-
vices and management contracts. Which of the following should the compli-
ance professional consider in analyzing the issue?: Anti-Kickback Safe
harbors
12.In an investigation, the MOST important responsibility of the
compliance professional is to: assure independence in all investigations
13.A compliance professional discovers non-compliance with a regulation.
Which of the following should the compliance professional do FIRST?:
Con- duct a baseline audit
14.A record retention policy must be based on: applicable state laws
15.Training is scheduled for employees to learn about cost reporting risks.
This type of training is an example of
a. online training
b. general training
c. focused training
d. orientation training: focused training
16.Which of the following are MOST relevant in evaluating the
effectiveness of a compliance training program?
1. percent of target audience that has attended
2. whether the training is computer-based on classroom-based
3. whether training adequately addresses areas of concern
4. improvement shown in pre- and post-training quizzes: 1, 3, and 4 only
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