HIMT 2460 DOMAIN V-COMPLIANCE | QUESTIONS AND
ANSWERS | 2026 UPDATE | 100% CORRECT
A good question for a supervisor of coding to ask when evaluating potential
fraud or abuse risk areas in the coding area is ______.
a. Are the assigned codes supported by the health record documentation?
b. Does the hospital have a compliance plan?
c. How many claims have not been coded?
d. Which members of the medical staff have the most admissions to the
hospital? Answer - a. Are the assigned codes supported by the health record
documentation?
A healthcare provider is accused of healthcare fraud and abuse for 32 incidents
in which they unbundled a chare resulting in an incorrect overpayment of $45
for each incident. the provider must pay back $1440 in overpayment. Calculate
the penalty payment.
a. $4,320
b. $362,112
c. $64,000
d. $324,320 Answer - b. $362,112
A provider that intentionally fails to comply with or is acting with indifference
to the HIPAA law is considered to be engaging in _________.
a. Fraud
b. Willful neglect
, c. Abuse
d. Unreasonable diligence Answer - b. Willful neglect
A study conducted by AHIMA found that credentialed coders who used a CAC
were able to reduce the amount of time it took to code a record by _______.
a. 50 percent
b. 22 percent
c. 30 percent
d. 40 percent Answer - b. 22 percent
ADR's are sent to healthcare provider on a ____________ day cycle
a. 30
b. 45
c. 60
d. 90 Answer - b. 45
An example of fraud is ________.
a. A pattern of coding errors such as upcoding or unbundling
b. Charging excessively for services or treatments
c. Billing for unnecessary services or treatments
d. Directing others to falsely document or bill Answer - d. Directing others to
falsely document or bill
An example of waste is _________________.
a. Shortage of supplies
b. Ordering more ancillary tests than may be required
c. Patients moved in efficient manner
ANSWERS | 2026 UPDATE | 100% CORRECT
A good question for a supervisor of coding to ask when evaluating potential
fraud or abuse risk areas in the coding area is ______.
a. Are the assigned codes supported by the health record documentation?
b. Does the hospital have a compliance plan?
c. How many claims have not been coded?
d. Which members of the medical staff have the most admissions to the
hospital? Answer - a. Are the assigned codes supported by the health record
documentation?
A healthcare provider is accused of healthcare fraud and abuse for 32 incidents
in which they unbundled a chare resulting in an incorrect overpayment of $45
for each incident. the provider must pay back $1440 in overpayment. Calculate
the penalty payment.
a. $4,320
b. $362,112
c. $64,000
d. $324,320 Answer - b. $362,112
A provider that intentionally fails to comply with or is acting with indifference
to the HIPAA law is considered to be engaging in _________.
a. Fraud
b. Willful neglect
, c. Abuse
d. Unreasonable diligence Answer - b. Willful neglect
A study conducted by AHIMA found that credentialed coders who used a CAC
were able to reduce the amount of time it took to code a record by _______.
a. 50 percent
b. 22 percent
c. 30 percent
d. 40 percent Answer - b. 22 percent
ADR's are sent to healthcare provider on a ____________ day cycle
a. 30
b. 45
c. 60
d. 90 Answer - b. 45
An example of fraud is ________.
a. A pattern of coding errors such as upcoding or unbundling
b. Charging excessively for services or treatments
c. Billing for unnecessary services or treatments
d. Directing others to falsely document or bill Answer - d. Directing others to
falsely document or bill
An example of waste is _________________.
a. Shortage of supplies
b. Ordering more ancillary tests than may be required
c. Patients moved in efficient manner
