CHC Practice Test Exam Questions with 100% Correct Answers, Exams of Advanced Education

Download CHC Practice Test Exam Questions with 100% Correct Answers and more Exams Advanced Education in PDF only on Docsity! CHC Practice Test Exam Questions with 100% Correct Answers | Verified | Latest Update AtiwhichileveliofitheiMedicareiPartiAioriBiappealsiprocessiisitheiappealir econsideredibyiaiqualifiediindependenticontractor? a.ifirstileveliappeal b.isecondileveliappeal c.ithirdileveliappeal d.ifourthileveliappeali-iCorrectiAnswer-b.isecondileveliappeal Thereiareifiveilevelsiofiappeal. Firstilevelientailsiairedeterminationioficlaim;isecondileveliinvolvesirecon siderationibyiaiqualifiediindependenticontractor;ithirdileveliincludesiaih earingioverseenibyiadminilawijudge;ifourthileveliisiaireviewiofiMedicarei ReviewiCouncil;iandififthileveliisiaijudicialireviewiinifederalicourt. Ifianiat- riskipatientiisileftiunattendediandihasianiadverseiresponseitoimedicatio n,ithisiisiknownias: a.isentinelievent b.iinitiator c.ilatentioutcome d.islipi-iCorrectiAnswer-a.isentinelievent Sentinelieventiisianiadverseioccurrenceithatiisinotiinitheinormaliprogres sioniofiaipatient'siillness.iInithisiscenario,ianiadverseidrugieventiisiconsid erediaisentinelievent.iANDiwheneveriaisentinelieventsiisiconfirmed,ithei facilityishouldiperformiaiRootiCauseiAnalysisi(RCA). AiLatentiOutcomei- ilessiapparentifailuresiofiorganizationioridesignithaticontributeditoitheie rror/patientiharm. AiSlipi-icanibeiaifalliorianieverydayiriskiatihospitals. Aibehavioralihealthispecialistinoticesiaiparticularlyihighinumberiofirestr aintideathsiatiaifacility.iAnianalysisiofitheirooticausesiofitheseieventsiisim ostilikelyitoiindicateiproblemsiwith: a.iEquipment b.iStaffiorientationianditraining c.iStaffingilevels d.iAlarmisystemsi-iCorrectiAnswer-b.iStaffiorientationianditraining Equipment,istaffingilevels,iandialarmisystemicanialsoibeiculpableiinirestr aintideaths,ibutiproblemsiwithiorientationianditrainingiareimuchimoreili kely. b.idraconian c.iconsistent d.iremediali-iCorrectiAnswer-a.icase-specific FSGitakesinumerousifactorsiintoiaccountiwhenideterminingipunishment .iTheirangeiofipenaltiesithatimayibeiapplieditoiaigiveniviolationiisibroad,i andiorganizationsimayiaffectitheiseverityiofitheiripunishmentiwithitheiri actionsisubsequentitoitheiviolation WhichiofitheifollowingigroupsimayirequestiinformationifromitheiHealth careiIntegrityiandiProtectioniDataiBank? a.iprofessionalisocietiesiwithiformalipeerireview b.iqualityiimprovementsiorganizations c.iplaintiff'siattorneys d.istateiagenciesi-iCorrectiAnswer-d.istateiagencies Otherigroupsimayiincludeifederaligovernment,ihealthiplans,ihealthcarei practitioners.iResearchersiareionlyialloweditoiobtainistatisticalidataifor mitheidataibank. Researchisuggestsithatitheilargestiproportionsiofiadverseieventsiattribu tableitoinegligenceioccuriinithe: a.ipost-traumaiunit b.isurgeryiunit c.imaternityiunit d.iemergencyiuniti-iCorrectiAnswer-d.iemergencyiunit AccordingitoititleiIIiofiHIPAA,idisclosureiofiProtectediHealthiInformationi relateditoiwhichiofitheifollowingiactionsirequiresitheipatient'siexpressiw ritteniauthorization? a.istateiiniwhichitheitreatmentioccur b.ihealthicareioperations c.itreatment d.ipaymenti-iCorrectiAnswer-a.istateiiniwhichitheitreatmentioccur AicoveredientityimayidiscloseiPHIiforiTPOi(treatment,ipayment,iandihea lthcareioperations) Whichiofitheifollowingigroupsiisileastilikelyitoireportierrors: a.iprimaryicareiphysicians b.isupportistaff c.iindependenticontractors d.inursesi-iCorrectiAnswer-c.iindependenticontractors WhyidoesiHealthcareiQualityiImprovementiActiprovideiconfidentialityia ndilegaliimmunityiforihealthicareipeerireviewiprocesses? a.itoipreventimalpracticeisuits b.itoidiscourageicomplaintsibyipatients c.itoiencourageiparticipationibyiphysicians d.itoimaintainiaisterileiworkienvironmenti-iCorrectiAnswer- c.itoiencourageiparticipationibyiphysicians TheiHealthcareiQualityiImprovementiActiprovidesiconfidentialityiandile galiimmunityiforihealthcareiPeeriReviewiprocessitoiencourageiparticipa tionibyiphysicians. Whichitypeiofisubpoenaicallsiforitheideliveryioficertainidocumentsitoith eicourt? a.isubpoenaihabeasicorpus b.isubpoenaiaditestificandum c.isubpoenaiaddiinfinitum d.isubpoenaiducesitectumi-iCorrectiAnswer-d.isubpoenaiducesitectum "subpoenaiaditestificandum"i- imeansitheicourtidemandsispecificipersoniappeariandigiveitestimony. Theiotherioptionsiareinotilegaliterms. WhichiofitheifollowingiisigenerallyiNOTiincludediinianiExplanationiofiBe nefitsi(EOB): a.idateiofiservice c.itheiprescriptionishouldinoticountitowardsitheipharmacy'siyield d.itheierrorishouldibeireporteditoitheiFDAi-iCorrectiAnswer- c.itheiprescriptionishouldinoticountitowardsitheipharmacy'siyield Theilegalidoctrineithatiassignsiresponsibilityitoiaidoctoriforitheibehaviori ofihisioriheriemployeeiis: a.iGoodiSamaritan b.iQuiiTam c.iRespondeatisuperior d.iResiipsailoquitori-iCorrectiAnswer-c.iRespondeatisuperior Resiipsailoquitorimeansi"theifactsispeakiforithemselves" Inigeneral,ihowimanyistepsishouldiaifailureimodesiandieffectsianalysisi(F MEA)iproceediinieachidirection? a.ione b.itwo c.ifive d.iteni-iCorrectiAnswer-b.itwo Two-partiprocess: 1.iidentificationiofierrors/defectsi(failureimodes). 2.iconsiderationioficonsequencesi(effectianalysis). Whichipieceiofilegislationimandatesitheicompaniesiwithisecuritiesilisted iinitheiUnitediStatesiabideibyigenerallyiacceptediaccountingipractices? a.iForeigniCorruptiPracticesiAct b.iEmergencyiMedicaliTreatmentiandiActiveiLaboriAct c.iFalseiClaimsiAct d.iCiviliMonetaryiPenaltiesiActi-iCorrectiAnswer- a.iForeigniCorruptiPracticesiAct Whichipieceiofilegislationimadeiquiitamilawsuitsipossible? a.iFairiLaboriStandardsiAct b.iFalseiClaimsiAct c.iFreedomiofiInformationiAct d.iEmergencyimedicaliTreatmentiandiActiveiLaboriActi-iCorrectiAnswer- b.iFalseiClaimsiAct Theiunethicalipracticeiofibillingiforiaimoreiexpensiveiserviceithaniisiactu allyiprovidediisiknownias: a.iupcoding b.iDRGicreep c.iunbundling d.ioverdiagnosisi-iCorrectiAnswer-b.iDRGicreep DRGiCreepirefersitoiupcodingibutispecificallyireferringitoiinpatientihospi talibillingicodesi(DRGicodes),ianditheihigherireimbursementicodeiisinotia ccuratelyireflectingitheisameiserviceiprovideditoipatienti(DRGicodesiaive ryicomplex).iFromitheiexampleiFrankiprovidedibelow,isprainediankleiisi notitheisameiasibrokeniankle. ExampleifromiFrankiaiwhileiback: "youihaveiaicoldibutitheiphysicianibillsiforitreatingiyouiwithitheiflu.iIniot heriwords,iyouihaveiaisprainediankleibutiIibillithatiyouihaveiaimoreicomp lexiissueilikeiaibrokeniankle" Upcodingi- itheiproviderimayibeiusingitheisameiservice/procedureicode,ibutihe/shei choosesitheioneithatioffersihigherireimbursementirate.iUsually,iupcodi ngiisiusediregardingiCPTicodes.iForiinstance:itheithreeiCPTicodesibelowia reiforitheisameiservicei"PTielevation".iButiyouicaniseeithereiisiaiminoridi fferentiation,ianditheihigheritheicomplexity,itheihigheritheireimbursem ent. 97161:iPTievaluationi-ilowicomplexity 97162:iPTievaluationi-imoderateicomplexity 97163:iPTievaluationi-ihighicomplexity ExampleifromiFrankiaiwhileiback: Upcoding...youireceivei15iminsiofiphysicalitherapyiservices...butitheiph ysicianibillsifori30iminutesiofi"advanced"iphysicalitherapyiservicesiIniot heriwords,iIigiveiyouiaihamburgeributiIibilliasiifiIigaveiyouiaisteakidinner. a.ilagitime b.ileaditime c.icriticalipath d.ifastitracki-iCorrectiAnswer-a.ilagitime PERTileaditimei- iintervaliwithiniwhichiaiproceedingieventimustibeifinisheditoiallowitimei toicompleteinextistepiiniprocess. PERTifastitracki- iacceleratingiprocessesibyiperformingiseveraliactivitiesiationce. Andicriticalipathiisitheiminimumidurationiofitheiproject. WhichiofitheifollowingiisiNOTioneiofitheiprerequisitesiforitheivoluntaryis elf-disclosureiprogramiadministeredibyitheiOIG? a.itheidisclosingipartyimustidescribeitheiwrongdoingianditheiharmithati mayihaveibeenicauseditoifederaliprograms b.itheidisclosureimayinotibeitheiresultiofiinvestigationioriaipendingiproc eeding c.itheidisclosureimustinotibeitheisubjectiofiaibankruptcyiproceeding d.itheidisclosureimustibeionibehalfiofianiindividualiratherithanianientityi- iCorrectiAnswer- d.itheidisclosureimustibeionibehalfiofianiindividualiratherithanianientity WhichiofitheifollowingiisiNOTioneiofitheicategoriesiofiobligationsioutline diinitheiCodeiofiEthicsiforihealthcareicomplianceiprofessionalsiissuedibyi theiHealthiCareiComplianceiAssociation? a.iobligationsitoitheipublic b.iobligationsitoitheigovernment c.iobligationsitoitheiemployingiorganization d.iobligationsitoitheiprofessioni-iCorrectiAnswer- b.iobligationsitoitheigovernment Beforeiconductingiaisafetyiauditiinianiemergencyidepartment,iandiadmi nistratorifirstineedsitoiobtain: a.iailistiofitheiemployeesiinithatidepartment b.iaimapiofitheidepartment c.iaiwrittenisetiofisafetyistandards d.istatisticsioniadverseieventsi-iCorrectiAnswer- c.iaiwrittenisetiofisafetyistandards WhichiofitheifollowingiisiNOTicoveredibyitheiStarkiLaw? a.iphysicianiservices b.iphysicalitherapyiservices c.iclinicalilaboratoryiservices d.ioccupationalitherapyiservicesi-iCorrectiAnswer-a.iphysicianiservices StarkiLawiisionlyiapplicableitoiDesignatediHealthiServicesi(DHS) TheisecretaryiofiwhichifederaliagencyioverseesitheiFDA? a.iOccupationaliSafetyiandiHealthiAdministration b.iGeneraliServicesiAdministration c.iDepartmentiofiHealthiandiHumaniServices d.iCenteriforiMedicareiandiMedicaidiContractorsi-iCorrectiAnswer- c.iDepartmentiofiHealthiandiHumaniServices TheiSecretaryiofitheiDepartmentiofiHealthiandiHumaniServicesioversees itheiFDA.iItialsoiadministersiMedicare,iMedicaid,iNIH,iandiAdministratio niforiChildreniandiFamilies. Inimostihospitals,itheireleaseiofiinformationidepartmentiisicomponenti of: a.iacuteiassessmentiunit b.imedicalirecordsidepartment c.iemergencyidepartment d.ihealthiinformationimanagementiservicesidepartmenti- iCorrectiAnswer- d.ihealthiinformationimanagementiservicesidepartment AccordingitoitheiInstituteiofiMedicine,iwhichiofitheifollowingiisiNOTionei ofitheidomainsiofiqualityioficare? Medicareicontractorsiuseithisirateiasiaiquickigaugeiofihowiclaimsierrorsi areiaffectingiMedicareiTrustiFund. Whichicaseiestablishedithatiaicorporateidirectorimayibreachihisioriherifi duciaryiobligationibyifailingitoifaithfullyiinstituteiaicomplianceiandiethic siprogram? a.iRushiPrudentialiv.iMorani(2002) b.iCaremarkiInternationaliDerivativeiLitigationi(1996) c.iWashingtoniStateiMedicaliAssociationiv.iRegenceiBlueShieldi(2007) d.iMedicaliAssociationiofiGeorgiaiv.iBlueCrossiofiGeorgiai(2000)i- iCorrectiAnswer-b.iCaremarkiInternationaliDerivativeiLitigationi(1996) Aiciviliactioniconcerningiaidirector'sidutyioficare.iCaremarkidirectorsibre acheditheiridutyioficareibyifailingitoiadequatelyisuperviseitheiriemploye esiwhenitheyiknew/should'veiknowniaiviolationiofilawiwasioccurring.iR ef:i698iA.2di959i(Del.iCh.i1996) WhichiofitheifollowingiisiNOTioneiofitheicriteriaicategoriesiidentifiedibyi theiClinicaliLaboratoryiImprovementiAmendmentsi(CLIA)? a.iaccuracy b.iinterpretationiandijudgement c.icalibration,iqualityicontrol,iandiproficiencyitestingimaterials d.itrainingiandiexperiencei-iCorrectiAnswer-a.iaccuracy SeeialliFDA-CLIAiCategorizations: https://www.fda.gov/medical-devices/ivd-regulatory-assistance/clia- categorizations WhichiofitheifollowingipiecesiofiinformationiisiavailableiinitheiHealthcar eiIntegrityiandiProtectioniDataiBank,ibutinotitheiNationaliPractitioneriD ataiBank? a.imedicalimalpracticeipayments b.icriminaliconvictionsirelateditoihealthcare c.ilossiofilicensure d.inegativeifindingsibyistateicertificationiauthorityi-iCorrectiAnswer- b.icriminaliconvictionsirelateditoihealthcare Whichiisitheimosticommonireasoniforiaicertificateiofimedicalinecessityit oirequireirecertification? a.ichangeiinitheihealthistatusiofitheipatients b.iresupplyiofioxygen c.ifailureitoirenewimedicaliapproval d.ichangeiofiaddressi-iCorrectiAnswer-b.iresupplyiofioxygen Whichiofitheifollowingistatementsiaboutiindividuallyiidentifiableihealthi informationi(IHI)iisifalse? a.iindividuallyiidentifiableihealthiinformationi(IHI)imayirelateitoifutureip aymentsiforihealthcare b.iindividuallyiidentifiableihealthiinformationi(IHI)imayibeireceivedibyia niemployer c.iindividuallyiidentifiableihealthiinformationi(IHI)iprovidesitheipatient' siname d.iindividuallyiidentifiableihealthiinformationi(IHI)imayibeicreatedibyiaih ealthcareiclearinghousei-iCorrectiAnswer- c.iindividuallyiidentifiableihealthiinformationi(IHI)iprovidesitheipatient' siname IdentifiableiIHIidoesinotinecessarilyiprovideipatient'siname,ibutiitidoesic ontainienoughiidentifyingiinformationithatiitimayibeireasonablyithatith einameiofitheipersonicanibeidiscovered. WhichiofitheifollowingiisiresponsibleiforitheimostiprivacyiviolationsiofiHI PAA? a.iimproperidisposaliofidata b.idataidisclosediwithoutitheiauthorizationiofitheipatient c.ilossiofidata d.iphysicalitheftiofidatai-iCorrectiAnswer-d.iphysicalitheftiofidata Physicalitheftidataiisinumberione.iTheisecondimostiisidataidisclosediwit houtitheiauthorizationiofipatient. AccordingitoitheiOIG,iwhichiofitheifollowingiwouldilikelyibeitheileastihel pfulimeasureiforiimprovingioutpatientiservices?