HAC Internal Controls & Fraud Prevention 5

Question 1

Which internal control activity ensures that recorded financial transactions are supported by appropriate source documents?

Accepted Answer

Documentation and record-keeping controls

Answer

Documentation controls require source documents (orders, contracts, invoices) to support every transaction entered into the accounting system.

Question 2

The 'tone at the top' concept in healthcare compliance primarily refers to:

Accepted Answer

Senior leadership's visible commitment to ethical conduct and compliance

Answer

Tone at the top reflects how senior leadership models and enforces ethical behavior, which cascades throughout the organization.

Question 3

A Compliance Effective Date (CED) in an OIG Corporate Integrity Agreement (CIA) marks:

Accepted Answer

The date the CIA obligations formally begin, typically the settlement effective date

Answer

The CED is the official start date of CIA obligations, from which all reporting timelines and annual review periods are measured.

Question 4

Which fraud triangle element is present when a healthcare billing manager justifies theft by believing the organization 'overcharges patients anyway'?

Accepted Answer

Rationalization

Answer

Rationalization is the mental justification a fraudster uses to excuse dishonest behavior as acceptable or deserved.

Question 5

An internal auditor uses data analytics to flag all claims where the date of service falls on a Sunday for a provider with no weekend hours. This technique is best described as:

Accepted Answer

Exception reporting

Answer

Exception reporting uses predefined rules to flag records that deviate from expected patterns, here identifying impossible service dates.

(HAC) Healthcare Accounting Certification Practice Test

(HAC) Healthcare Accounting Certification Practice Test

HAC Internal Controls & Fraud Prevention 5