AAHAM Certified Compliance Technician (CCT) Practice Test

These questions are part of the practice quiz. Start practicing

• Which is a stated benefit of an effective compliance plan?
• Providing medically unnecessary services is an example of
• Which of the following is an example of complaints?
• Semi-automated review is described as which of the following in Medicare recovery auditing?
• Which CLIA certificate is the provider-performed microscopy certificate?
• ASHI stands for which organization?
• Which is not a step in the RAC appeals process?
• Recent amendments to the act expand and place additional requirements on Credit Reporting Agencies (CRAs). These amendments are associated with which act?
• ICD-10-PCS is used for what?
• Which option is not a component of the Office of Inspector General?
• COC stands for which term?
• EMTALA stands for which of the following?
• What is the major goal of the Privacy Rule?
• EMTALA stands for?
• Appeals Council Review is which level?
• Noncompliant activities can trigger which penalties?
• OAS is a component of the Department of which U.S. department?
• Which acronym represents the Office of Inspector General?
• The ALJ hearing is which level of Medicare appeal, and what was the 2012 amount in controversy threshold?
• Health Care Fraud and Abuse Control was established by which act?
• Which is NOT an element of an effective compliance plan?
• The recipient of a contract to guard the operations of the Medicare Trust Fund is called which term?
• EMTALA prohibits hospitals from refusing to examine or treat individuals with which condition?
• How many Fraud Alert types exist under the BI Unit Alert/Program Safeguard/Zone Program Integrity framework?
• Which option is NOT among the Four Administrative Simplification provisions?
• Certificate of Waiver stands for?
• Which term is used to describe the first level of appeal in Medicare claims?
• CLIA certificates have a standard validity period. Which of the following statements is true?
• Focused field audit describes?
• Fair Credit Reporting Act is best described by which statement?
• COA stands for which term?
• Which documents are associated with verifying service details under CMS complaints?
• Which statement describes ICD as used in medicine?
• ICD-10-C.M. stands for what and what is its purpose?
• Which of the following is an example of fraud?
• In ICD-10 coding, what is true about the second character?
• HITECH stands for which act?
• AABB is one of six CMS-approved accreditation organizations.
• In Medicare terminology, 'providers' refers to what?
• A Certificate of Waiver authorizes a laboratory to perform which type of tests?
• Reconsideration is which level of appeal in the Medicare claims process?
• Which action is explicitly identified as the response component in an effective compliance plan when offenses are detected?
• Which term refers to a private contractor performing audits under CMS contract?
• The International Classification of Diseases (ICD) is primarily used for what purpose?
• CAP stands for which organization?
• Under the Fair Credit Billing Act, if timeframes are not met, what may occur?
• In payer denial appeals, what is Judicial Review?
• What does HCQIP promote?
• AOA stands for which organization?
• Which term describes a private company contracted by CMS to perform audit-related activities?
• Which of the following is an administrative sanction for inappropriate and/or fraudulent behavior on the part of the provider?
• OEI Evaluations focus on which aspect?
• Using another individual's Medicare Insurance card to obtain medical care is an example of
• What is the purpose of a Corporate Integrity Agreement in healthcare?
• Medicare Secondary Payer (MSP) primarily aims to protect which fund?
• Which of the following is a Fraud Alert type?
• Which statement describes the term remuneration?
• The RAC Data Warehouse serves primarily as which of the following?
• Which entity administers the CLIA requirements and issues CLIA certificates?
• Certificate of Compliance stands for?
• What is automated review in this context?
• Certificate of Registration stands for?
• What does HIPAA stand for?
• GAO is the acronym for which U.S. government entity?
• Capture of physician notes is one of the main functions of EHRs/EMRs.
• According to Medicare oversight, which entity is responsible for evaluating and certifying hospitals for compliance?
• Which of the following is NOT listed as a type of Technical safeguard?
• Which acronym stands for the center that supports Quality Improvement Organizations?
• Safe Harbor provisions are designed to identify payment and business practices that would not be prosecuted.
• The BI Unit Alert is associated with which group?
• Submitting a claim at a higher level of service than rendered (up-coding) is an example of
• Which full name corresponds to the act abbreviated as HITECH?
• What are the categories of improper payments in healthcare claims?
• What does MAC stand for in the Medicare context?
• Fraud is defined as which of the following?
• Which statement describes a Corporate Integrity Agreement?
• Which term refers to regulations that identify specific payment and business practices that, while potentially prohibited by the Anti-Kickback Statute, would not be prosecuted?
• What is the major difference between ICD-9 and ICD-10?
• Which of the following is NOT listed as a type of Technical safeguards?
• NPI stands for which of the following?
• Under FDCPA, collectors are prohibited from communicating with the consumer at
• Which OIG component conducts national evaluations to provide Congress, HHS, and the public with timely, useful, and reliable information on significant issues?
• PPACA stands for which Act with a 60-day obligation to report and return identified overpayments?
• A RAC denial causing a partial denial would be issued by which entity?
• Operation Restore Trust is described as which type of program?
• Which acronym stands for the electronic medical record?
• RAC stands for Recovery Audit Contractor; what does RAC stand for?
• Focused desk review describes?
• Which act defines what information from consumer reports can be used, by whom, and when?
• Which of the following is a Waiver Alert?
• Security Standards are divided into three categories. Which of the following lists those three categories?
• Which office is the principal driver in the implementation of compliance within HHS?
• Which entity is responsible for investigating provider fraud and reviewing complaints of resident abuse in nursing homes?
• EMR stands for which of the following?
• Charging in excess for services or supplies is an example of
• Which item is described as part of a Privacy Notice?
• Which activity is a ZPIC responsibility?
• The acronym QIOSC stands for which of the following?
• What is the primary function of Zone Program Integrity Contractors (ZPIC) in CMS oversight?
• Which acronym stands for the act intended to accelerate the adoption of electronic health records and clinical health information technology?
• The Truth in Lending Act is commonly associated with which concept?
• Which OIG component conducts financial and performance audits of departmental programs, operations, grantees, and contractors?
• A full denial occurs when the RAC determines that the service billed to CMS was not rendered or was not reasonable or necessary. Which term does this describe?
• AOA is one of six CMS-approved accreditation organizations.
• Which agency instituted the Comprehensive Error Rate Testing program?
• EMTALA is also known as the Federal Anti-Dumping Statute. Which option correctly names this statute?
• Which OIG component conducts investigations of fraud and misconduct related to the Department's programs, operations, and beneficiaries?
• CERT stands for what?
• Which acronym is associated with the program "Graduate Medical Education"?
• Which entity evaluates and certifies hospitals for compliance with Medicare requirements?
• OCIG is the Office of Counsel to the Inspector General. What is its primary function?
• Which term is used to describe reducing wait time for patients and providers as per IOM aims?
• Which activity is NOT part of the CMS survey process for CLIA compliance?
• How many CMS-approved accreditation organizations exist for CLIA?
• Which acronym corresponds to the Office of Evaluation and Inspections?
• Which two government entities produce annual reports reviewing Medicare payments?
• FDCPA prohibits
• What are the three types of MIC audits?
• Which statement about CLIA certificates is true?
• What does the acronym MIC stand for in this material?
• Which office is responsible for enforcing the HIPAA Privacy Rule?
• Which item is included as a core element of a CIA?
• HIPAA stands for which act?
• Fair Debt Collection Practices Act Imposes strict limitations on
• Providing medically unnecessary services is an example of
• The Telephone Consumer Protection Act of 1991 restricts which activities?
• Which organization corresponds to Region D?
• Fair Debt Collection Practices Act is associated with which Title of the Consumer Credit Protection Act?
• Penalty for false pretenses under privacy rule violations?
• Which entities could be violators of fraud in the compliance context?
• Under Medicare hospital accreditation considerations, which statement is true?
• Which organization is CMS-approved and commonly used to certify hospitals?
• Which of the following is NOT one of the four main functions of EHRs/EMRs?
• CIA stands for Corporate Integrity Agreement; what is its purpose?
• EPHI stands for which of the following?
• Which of the following is NOT one of IOM's six aims?
• FDA stands for which of the following?
• EHR stands for?
• PHSA stands for Public Health Service Act; what does the Act provide regarding CLIA in states with equal to or more stringent requirements?
• According to the HIPAA Security Rule, Administrative Safeguards refer to which concept?
• Which acronym refers to a private contractor that performs CMS audits?
• HCFAC stands for which program?
• Which entity renders advisory opinions, issues fraud alerts, and provides guidance to the healthcare industry concerning the federal Anti-Kickback Statute and OIG sanctions?
• Which statement is true about ASCA?
• Unbundling or 'exploding' charges is an example of
• CPG stands for?
• Which of the following is NOT a listed benefit of ICD-10?
• Which organization accredits healthcare organizations?
• Which statement best describes a CMS Central Office Alert?
• Which organization corresponds to Region C?
• Remuneration is defined as which of the following?
• Which item is NOT described by a Privacy Notice?
• Which abbreviation stands for the Office of Evaluation and Inspections?
• Which statement best describes the purpose of Access Control within Technical safeguards?
• Which act provides for exemption from CLIA if state requirements are equal to or more stringent than CLIA's?
• Fraud alerts are issued to advise governmental agencies about activities that have resulted in what?
• COLA stands for which term?
• Which acronym represents a CMS mission-supporting program to assure healthcare security for beneficiaries?
• Which entity represents the Office of Inspector General in civil and administrative fraud and abuse cases involving HHS programs, including the False Claims Act and program exclusions?
• Which category focuses on administrative controls such as policies and procedures?
• Which OIG component provides legal advice and representation to the OIG on the matters relating to Medicare, Medicaid, and other HHS programs and operations?
• Redetermination is which level of appeal in Medicare claims?
• EMC stands for?
• Partial denial describes a RAC denial in which the service was not reasonable or necessary but a lower level service would be, or when the service was upcoded or an incorrect code submitted which yielded a higher reimbursement.
• Equitable is which IOM aim?
• Truth in Lending Act is also known as Regulation what?
• Which statement best defines a hospital?
• Which organization is an accreditation body approved by CMS?
• Which organization is COLA in the context of laboratory accreditation?
• CMS Central Office Alert is described as which of the following?
• Billing non-covered or non-chargeable services as covered items is an example of
• Which program identifies improper Medicare payments and fights fraud, waste, and abuse?
• Which OIG component conducts and coordinates investigations of fraud and misconduct related to the Department's programs, operations, and beneficiaries?
• Which states have earned CLIA exemption status?
• What does CERT stand for?
• EMTALA is primarily concerned with ensuring access to which of the following?
• What best describes the purpose of Physical Safeguards?
• Which acronym was created to accelerate adoption of electronic health records among providers?
• What does COC stand for in CLIA terminology?
• What is a complex review?
• What do RACs do?
• Submitting bills to Medicare that are the responsibility of other insurers is an example of
• What is the purpose of reporting adverse events?
• What does OAS stand for within the OIG?
• DOJ stands for?
• What is the correct sequence for the five levels of RAC appeals?
• COW stands for?
• TJC is the acronym for which organization?
• IME stands for?
• What is the MIC audits objective?
• The Health Care Eligibility Benefit Inquiry and Response (270/271) is an example of which HIPAA standard?
• COP stands for?
• Health Care Claim Institutional (837I) and Health Care Claim Professional (837P) are examples of which HIPAA standard?
• What does CLIA stand for?
• Which CLIA certificate is abbreviated COA?
• Which organization is Region B for RACs?
• Violating the Anti-Kickback Statute can result in which penalties?
• What is the purpose of performance audits?
• Which term refers to the program established to combat waste, fraud and abuse in Medicare and Medicaid?
• CMS aims to reduce the percentage of Medicare dollars paid by identifying various issues. Which of the following is NOT listed among those targets?
• Which is a core element of a CIA?
• PCCM stands for which program model?
• Which office negotiates and monitors Corporate Integrity Agreements?
• Provider- Self Discloser Protocol is a publication by which agency to promote voluntary disclosure of potential violations?
• EHRs/EMRs support which outcome?
• Transmission security is a type of Technical safeguard designed to protect data in transit. Data in transit means:
• Anti-Kickback Statute prohibits which?
• Penalty for intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain, or malicious harm?
• IOM stands for?
• The CMS surveyor determines whether the lab is meeting the requirements of CLIA regulations based on
• What is a potential benefit of self-disclosure to the OIG?
• ASCA stands for which Act?
• What are the two types of systems for reporting adverse events?
• Which term stands for electronic protected health information?
• PHI stands for which term?
• What does PPM stand for in the CLIA context?
• Appeals Council Review is which level in the Medicare appeal process?
• Which of the following is NOT a core element of a Corporate Integrity Agreement?
• OCIG is the abbreviation for which OIG component?
• PPM stands for Provider Performed Microscopy.
• What are the three review processes RACs follow to identify improper payments?
• Fair Credit Billing Act is best described by which statement?
• Which of the following is considered an Administrative Safeguard type?
• Which act provides exemption from CLIA requirements in certain states?
• Altering claim forms to obtain a higher payment is an example of
• What does ORT stand for in the context of Medicare and Medicaid fraud disclosure programs?
• To enroll in the CLIA program, a laboratory must
• Billing for medically unnecessary services is an example of
• Zone Program Integrity Contractors, or ZPICs, are used by CMS to do what?
• Breaches in the assignment of benefits are described as what?
• Under PPACA, overpayments must be reported and returned within how many days after identification?
• ICD-10-PCS is used to code what type of data?
• Performance audits focus on what?
• OCIG is the abbreviation for which office?
• Billing Medicare for services that should be billed to another insurer is an example of
• Which set of items is among the four Administrative Simplification provisions?
• What is a demand letter?
• What action may be taken if there is reliable evidence of fraud?
• Which organization is Region B for RACs?
• Which statement about RACs may not identify improper payments from other programs?
• Which item is one of the five types of Fraud Alerts?
• Which of the following is one of the four main functions of EHRs/EMRs?
• Which is a type of Physical Safeguard?
• Which statement describes a Certificate of Accreditation (COA) under CLIA?
• OAS stands for which office that conducts financial and performance audits?
• Providing services that do not meet professional recognized standards is an example of
• How does CMS define a complaint?
• How many RACs were involved in the initial demonstration project?
• Which item is not listed as a ZPIC priority?
• HHS stands for which department?
• Which statement about the RAC Data Warehouse is correct?
• Providing services that do not meet professional recognized standards is an example of
• Which item is included in MFCU Performance Standards?
• What does GAO stand for?
• Which of the following statements about Appeals Council Review is true?
• In ICD-10 coding, what can the third character be and where is the decimal placed?
• Under EMTALA, hospitals with emergency departments must provide which of the following to individuals who come to the ED and request it?
• Which CLIA certificate allows provider-performed microscopy?
• GME stands for which program?
• Which statement about the National Medicare Fraud Alert (NMFA) is accurate?
• Which is a stated benefit of an effective compliance plan?
• HCQIP stands for which program?
• Which statement accurately describes hospital accreditation and Medicare requirements?
• Which outcome is associated with early detection and reporting in a compliance program?
• CAP is one of six CMS-approved accreditation organizations. What does CAP stand for?
• The organization formerly known as JCAHO is now commonly called what?
• ASHI stands for which organization?
• What does COLA stand for in the accreditation context?
• False Claims Act is best described by which statement?
• In ICD-10 coding, what is true about the first character?
• Qui tam provisions are part of which federal statute?
• What does CMP stand for?
• HPMP stands for what abbreviation?
• What are the two types of RAC denials?
• JCAHO stands for?
• Which item is considered a ZPIC priority?
• Which standard transaction covers Health Care Claim Payment/Advice?
• The ALJ hearing represents which level in the Medicare appeal process?
• What does HITECH stand for?
• AABB stands for which organization?
• Which office issues advisory opinions and fraud alerts regarding the Anti-Kickback Statute and OIG sanctions?
• Fair Debt Collection Practices Act is best described by which statement?
• Which organization corresponds to Region A?
• A Recovery Audit Contractor is best described as which of the following?
• What is the primary goal of the CLIA program?
• Waiver Alerts are described as which category?
• Which action is NOT a core element of a CIA?
• Certificate of Accreditation stands for?
• Comprehensive MIC audit describes?
• The abbreviation OCR refers to which office?
• Which Medicare-related alert is most commonly issued and highlights a specific scheme or scam?
• Unbundling or exploding charges is an example of
• OEI Evaluations focus on which of the following?
• What is the primary purpose of financial audits?
• ASHI stands for which organization?
• Which is an example of a complaint?
• The Social Security Act mandates the establishment of what standards for suppliers and providers participating in Medicare and Medicaid?
• Recovery Audit Programs are a program created by Congress to identify improper Medicare payments and to fight fraud, waste, and abuse in the government program. Which statement best describes its primary purpose?
• Who can file complaints?
• MedWatch is an FDA reporting system designed to encourage reporting of adverse events due to what cause?
• OEI Evaluations focus on promoting economy, efficiency, and effectiveness of departmental programs.
• OCIG is a component of which office?
• Which of the following is NOT typically listed as an Administrative Safeguard type?
• Technical safeguards are defined as
• Federal Anti-Dumping Statute is another name for which Act?
• Whom may a case be referred to for civil or criminal prosecution?
• What does CMS stand for?
• ASCA stands for which of the following?
• National Medicare Fraud Alert is one of the five Fraud Alert types and focuses on what?
• What does COW stand for in the CLIA context?
• Penalty for obtaining or disclosing individually identifiable health information under the privacy rule?
• IME stands for which concept?
• ICD stands for?
• HCQIP participation is voluntary; providers may decline to participate without penalty if issues.
• Which accreditation combination deems Medicare requirements are met for hospitals?