Fraud waste abuse - Study guides, Class notes & Summaries
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AHIP TRAINING Medicare Fraud, Waste, and Abuse Training | Latest Version 2024/2025 | Expert Verified | Ace the Test
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AHIP TRAINING Medicare Fraud, Waste, and Abuse Training | 
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2024 Anthem Administrative Guidelines Exam
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2024 Anthem Administrative Guidelines Exam 
 
I completed all my training on Friday. When will I know I'm ready to sell? - ANS Only after receipt of the confirmation email should arrive on Monday. Training completed one day should be validated the following business day. 
 
What tool does BlueCross provide for you to submit notes taken during the meeting with a prospect? - ANS Cavulus 
 
If a member chooses to cancel or withdraw an enrollment application or terminate enrollment in a plan o...
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HCCA – CHPC EXAM ACTUAL EXAM AND STUDY GUIDE LATEST COMPLETE 500+ QUESTIONS AND CORRECT DETAILED ANSWERS JUST RELEASED
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HCCA – CHPC EXAM ACTUAL EXAM AND STUDY GUIDE LATEST COMPLETE 500+ QUESTIONS AND CORRECT DETAILED ANSWERS JUST RELEASED 
 
What is the purpose of HIPAA? - CORRECT ANSWERS • Protect PHI from unauthorized disclosure/use; 
• Prevent fraud, waste and abuse (via Administrative Simplification); 
• Make health insurance portable under ERISA; 
• Move health care onto a nationally standardized electronic billing platform 
 
Ref. 
More on HIPAA: 
 
HIPAA resides in which CFR section? - CORR...
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Fraud, Waste, and Abuse for 2023 | Questions with 100% Correct Answers | Updated & Verified
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Compliance is the responsibility of the Compliance Officer, Compliance Committee, and Upper 
Management only. - False 
Ways to report a compliance issue include: 
a. Telephone hotlines 
b. Report on the Sponsor's website 
c. In-person reporting to the compliance department/supervisor 
d. All of the above - d. All of the above 
What is the policy of non-retaliation? 
a. Allows the Sponsor to discipline employees who violate the Code of Conduct 
b. Prohibits management and supervisor from harassi...
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UNITED HEALTHCARE (UHC) – ETHICS AND COMPLIANCE LATEST 2023-2024 EXAM| ACTUAL QUESTIONS AND VERIFIED ANSWERS |A+ GRADE
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UNITED HEALTHCARE (UHC) – ETHICS AND COMPLIANCE LATEST 2023-2024 EXAM| ACTUAL QUESTIONS AND VERIFIED ANSWERS |A+ GRADE 
 
Q: Agent Jacob learns that Emily, the consumer with whom he is meeting, is the authorized legal representative for her father. What must Jacob explain to Emily when completing an Enrollment Application for her father? 
 
 
Answer: 
Jacob must explain that Emily will sign the Enrollment Application and must be able to provide documentation upon request by the Plan that indic...
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AHIP TRAINING Medicare Fraud, Waste, and Abuse Training EXAM 50+ QUESTIONS AND VERIFIED CORRECT ANSWERS 2023.
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AHIP TRAINING Medicare 
Fraud, Waste, and Abuse 
Training EXAM 50+ 
QUESTIONS 
AND VERIFIED CORRECT 
ANSWERS 2023. 
AHIP TRAINING Medicare Fraud, Waste, and Abuse Training 
1. Medicare plan means: A MA plan, MA-PD plan or PDP 
2. Subcontractor means: **An individual or entity that provides services on behalf 
of a Medicare plan sponsor. This includes individuals and organizations with 
DIRECT relationship with the plan sponsor or individuals or organizations with 
INDIRECT relationship, such as ...
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MEDICARE+ FRAUD, WASTE, AND ABUSE 2024 WITH VERIFIED CORRECT ANSWERS.
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Your job is to submit a risk diagnosis to the Centers for Medicare & Medicaid Services (CMS) for the purpose of payment. As part of this job, you use a process to verify the data is accurate. Your immediate supervisor tells you to ignore the Sponsor's process and to adjust or add risk diagnosis codes for certain individuals. What should you do? 
Report the incident to the compliance department (via compliance hotline or other mechanism) 
 
 
 
You are performing a regular inventory of the contr...
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Fraud Waste and Abuse (FWA)Bundled Exams Questions and Answers (2022/2023) (Certified Solutions)
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Fraud Waste and Abuse (FWA)Bundled Exams Questions and Answers (2022/2023) (Certified Solutions)
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UNITED HEALTHCARE (UHC) – ETHICS AND COMPLIANCE LATEST 2023-2024 EXAM| ACTUAL QUESTIONS AND VERIFIED ANSWERS Version 2 |A+ GRADE
- Exam (elaborations) • 17 pages • 2023
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UNITED HEALTHCARE (UHC) – ETHICS AND COMPLIANCE LATEST 2023-2024 EXAM| ACTUAL QUESTIONS AND VERIFIED ANSWERS Version 2 |A+ GRADE 
 
 
Q: John has Power of Attorney to act on behalf of his mother. What does that mean when it comes to his mother enrolling in a Medicare Advantage Plan? 
 
 
Answer: 
John may sign the Enrollment Application and must be able to provide documentation upon request by the Plan that indicates his authority under state law to enroll his mother. 
 
 
 
Q: In which of the...
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HCCA CHC Exam Prep | 750+ Questions and Verified Answers| 2023/ 2024
- Exam (elaborations) • 222 pages • 2023
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HCCA CHC Exam Prep | 750+ Questions and Verified Answers| 2023/ 2024 
 
Q: True of False: 
A self-audit is an examination or inspection for providers in reducing non-compliance. Self-audits can lower chances of an external audit and create a robust culture of compliance 
 
 
Answer: 
True 
 
Source: CHC Exam Secrets Study Guide 
 
 
 
Q: CMS released areas of high-risk fraud, some of those include: 
A. Sudden changes in billing and billing inappropriate specialties 
B. Billing of inappropriate d...
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Fraud Waste and Abuse Test | 50 Questions with 100% Correct Answers | Updated & Verified
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ACA Section 1557 differs from earlier legislation in providing broader protection against 
discrimination based on - sex 
Section 1557 of the Affordable Care Act applies to - c. all health programs and activities 
administered by or receiving federal financial assistance from HHS. Correct 
Which Medicare programs are covered by ACA Section 1557? - a. Parts A, C, and D, but not 
B. Correct 
Under ACA Section 1557, prohibited actions involve - d. eligibility, claims, and marketing. 
Correct 
Under...
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