CHC EXAM 2024 (CERTIFIED HEALTH CARE CONSTRUCTOR) 2 NEWEST VERSIONS (VERSION A AND B) COMPLETE 250 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+

1 | P a g e CHC EXAM 2024 (CERTIFIED HEALTH CARE CONSTRUCTOR) 2 NEWEST VERSIONS (VERSION A AND B) COMPLETE 250 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ A health system implemented an EHR in 55 clinics. The privacy professional is told employees are inconsistently interpreting the policy addressing employee access to EHR. Which of the following is the privacy professional's BEST strategy? a. Collaborate with HR to ensure appropriate discipline b. Perform an audit under Attorney-Client Privilege c. Conduct surveys of clinic employees concerns d. Audit a random sampling of clinics across the organization - ANSWER- c. Conduct surveys of clinic employees concerns Under the US Federal Sentencing Guidelines, there is an expectation that effective compliance programs include due diligence in discretionary authority and hiring. Which of the following is MOST important process to include? a. Periodic background checks b. Drug Testing c. Monthly exclusion verifications through OIG database d. Monthly exclusion verifications through SAMS GSA Exclusion database - ANSWER- d. Monthly exclusion verifications through SAMS GSA Exclusion database. 2 | P a g e Explanation: Starting from the top: GSA administers SAM, which contains debarment actions taken by various Federal agencies, including OIG's exclusions. The LEIE contains only the exclusion actions taken by OIG. What are the 2 types of OIG exclusions? - ANSWER- Mandatory and Permissive. Concurrent Audit - ANSWER- Real time - Ongoing review/inspection of records, policies and procedures. More difficult to execute but best way to change behavior. Identify and address problems as they arise - Example: Auditing claims before claims are billed What is DRG Creep - ANSWER- Using a Diagnosis Related Group (DRG) code that provides a higher payment rate than the DRG code that accurately reflects the service furnished to the patient. In Compliance Auditing & Monitoring, Contemporaneous Reviews: a. Involves matter that either have not yet been billed by provider or have not yet been paid by the third party payor b. Appropriate to determine an initial baseline view of a particular billing practice or activity c. Can uncover existence of past problems e. All of the above 3 | P a g e f. A and B only - ANSWER- e. All of the above Retrospective Audit - ANSWER- Baseline assessment of where you are at a period of time in the past Snapshot or Laundry list of things needed to be fixed Need to know a milestone to go back to in time (e.g.; published financial statements, historical audit) Retrospective vs Concurrent Audit can be characterized by... - ANSWER- Retrospective milestone to go back to in system, you know the sample unit from system. Concurrent any time up to the final, real time The claims department needs to determine the initial baseline view of a particular billing practice to represent the beginning of a review process. What type of audit should be conducted? a. A probe audit b. Retrospective Audit c. A contemporaneous review d. Retroactive audit - ANSWER- c. A contemporaneous review The Compliance Officer is working with the Compliance Committee to develop goals of a review from a compliance perspective. What is the first thing that should be done? a. Conduct a probe audit on claims b. Take a "snapshot" to develop a baseline to assess the current state of compliance 4 | P a g e c. Conduct a contemporaneous review d. Conduct a concurrent audit - ANSWER- b. Take a "snapshot" to develop a baseline to assess the current state of compliance The type of audit used to identify potential errors prior to completing the process or transaction under review is: a. Operational audit b. Concurrent audit c. Retrospective audit d. Baseline audit - ANSWER- b. Concurrent audit Upcoding - ANSWER- Using a billing code that provides a higher reimbursement rate than the billing code that actually reflects the service furnished. Major focus of OIG enforcement efforts and HIPAA added additional civil monetary penalty to OIG sanctions. True or False: Encryption is required under HIPAA - ANSWERFALSE - It is an addressable implementation specification. Which of the following is one objective of a baseline audit? a. Evaluate compliance program operations b. Investigate an alleged violation c. Offer recommendations regarding necessary remediation