CERTIFIED IN
HEALTHCARE
COMPLIANCE CHC
PRACTICE TEST
Question 1: A health system is revising its code of conduct. Which approach best supports an eective compliance program?
Choices:
1) Align behavioral expectations with the organization's mission, values, and ethical principles 2) List only prohibited billing practices 3) Limit the code to employees who submit claims 4) Replace detailed policies with the code of conduct Correct Answer: Align behavioral expectations with the organization's mission, values, and ethical principles Explanation: A code of conduct should translate the organization's mission, values, and ethical principles into expected behavior. It complements rather than replaces detailed policies and should apply broadly across the organization.Page 1
Question 2: Which reporting relationship best supports the compliance ocer's independence?
Choices:
1) The compliance ocer reports only to the chief revenue ocer 2) The compliance ocer has direct access to the governing body or an appropriate board committee and sucient authority to raise concerns 3) The compliance ocer may communicate with the board only through outside counsel 4) The compliance ocer reports exclusively to the department most frequently audited Correct Answer: The compliance ocer has direct access to the governing body or an appropriate board committee and sucient authority to raise concerns Explanation: Independence is strengthened when the compliance ocer has sucient authority, resources, and direct access to the governing body or an appropriate board committee rather than being controlled by an operational function subject to compliance oversight.Question 3: Before hiring a billing specialist who will support claims to federal healthcare programs, what is the most appropriate exclusion-screening control?
Choices:
1) Screen only after the employee's probationary period 2) Rely on the applicant's statement that no exclusion exists 3) Check the OIG LEIE before hire and follow the organization's process for other applicable sanction lists 4) Screen only licensed clinicians Correct Answer: Check the OIG LEIE before hire and follow the organization's process for other applicable sanction lists Explanation: OIG urges healthcare entities to check the LEIE before hiring or contracting.Organizations should also apply their process to other relevant sanction sources based on their obligations and risk prole.Page 2
Question 4: What is the best objective for general compliance training provided to new hires?
Choices:
1) Teach every employee advanced coding rules 2) Replace department-specic training 3) Provide legal advice about personal liability 4) Ensure employees understand the code of conduct, key policies, reporting channels, nonretaliation expectations, and responsibilities relevant to their roles Correct Answer: Ensure employees understand the code of conduct, key policies, reporting channels, nonretaliation expectations, and responsibilities relevant to their roles Explanation: General training should establish the organization's compliance expectations and explain how employees can recognize, prevent, and report concerns. Risk-specic education should then be tailored to particular roles.Question 5: Which statement best distinguishes ongoing monitoring from auditing?
Choices:
1) Monitoring is typically built into operational processes, while auditing is a more formal, objective review that may be independent of the activity being examined 2) Auditing is performed only by government agencies 3) Monitoring always uses statistical samples and auditing never does 4) There is no practical dierence Correct Answer: Monitoring is typically built into operational processes, while auditing is a more formal, objective review that may be independent of the activity being examined Explanation: Monitoring is commonly performed as part of ongoing operations to detect and manage risk, while auditing is a more formal review designed to test compliance and should be objective and appropriately independent.Page 3