CHC - Certified in Healthcare Compliance Internal Investigations Questions and Answers

Question 1

A compliance officer begins an internal investigation into a billing department employee based on a credible whistleblower report alleging upcoding.
To best preserve the attorney-client privilege during the investigation, which of the following is the MOST critical step to take at the outset?

Accepted Answer

Engage legal counsel to direct and oversee the investigation.

Answer

Immediately suspend the employee pending the outcome of the investigation.

Answer

Notify the OIG of the potential issue via their self-disclosure protocol.

Answer

Interview the accused employee before they have a chance to alter records.

Question 2

During an internal investigation interview regarding potential HIPAA violations, the compliance officer is questioning a witness who seems hesitant and fearful of retaliation. Which of the following interview techniques is most appropriate to encourage open communication?

Accepted Answer

Explaining the non-retaliation policy and conducting the interview in a private, neutral setting.

Answer

Reminding the employee that failure to cooperate could result in disciplinary action.

Answer

Conducting the interview in a busy, open-plan office to appear less formal.

Answer

Asking leading questions to quickly confirm the suspected violations.

Question 3

A hospital's compliance department concludes an internal investigation that substantiates improper billing to a federal healthcare program, resulting in a significant overpayment. According to federal law and OIG guidance, what is the organization's primary obligation after quantifying the overpayment?

Accepted Answer

Report and return the overpayment within 60 days of its identification.

Answer

Discipline the employees responsible for the improper billing.

Answer

Wait for the next scheduled quarterly audit to report the findings.

Answer

Implement a new training program for the entire billing department.

Question 4

Which of the following BEST describes the primary purpose of creating an investigation plan before beginning interviews and data collection?

Accepted Answer

To define the scope, objectives, timeline, and resources needed for a thorough and impartial review.

Answer

To satisfy the Board of Directors that the compliance department is taking action.

Answer

To provide a formal report to the government in case of a future inquiry.

Answer

To predetermine the outcome and identify the responsible parties quickly.

Question 5

A compliance investigator is collecting electronic evidence as part of an inquiry into data tampering. To ensure the evidence is admissible in potential future legal proceedings, what is the most important principle to follow?

Accepted Answer

Interviewing the IT staff about their opinion on who may have altered the data.

Answer

Making multiple copies of the data and distributing them to the investigation team.

Answer

Maintaining a clear and documented chain of custody for the evidence.

Answer

Printing hard copies of all electronic files for the investigation binder.

Question 6

After completing an internal investigation that substantiated a violation of the organization's code of conduct, what is a critical final step in the investigation process?

Accepted Answer

Identifying the root cause and implementing corrective actions to prevent recurrence.

Answer

Informing all employees via a company-wide email about the outcome.

Answer

Archiving the investigation file in a publicly accessible folder for transparency.

Answer

Immediately terminating the subject of the investigation without further review.

A compliance officer begins an internal investigation into a billing department employee based on a credible whistleblower report alleging upcoding.To best preserve the attorney-client privilege during the investigation, which of the following is the MOST critical step to take at the outset?

A compliance officer begins an internal investigation into a billing department employee based on a credible whistleblower report alleging upcoding.
To best preserve the attorney-client privilege during the investigation, which of the following is the MOST critical step to take at the outset?