AHIMA Compliance and Legal 1 — Questions and Answers
Question 1: What is healthcare compliance?
- Adhering to laws, regulations, and ethical standards governing healthcare operations (Correct answer)
- Hospital cleanliness
- Patient compliance with treatment
- Insurance claim processing
Correct answer: Adhering to laws, regulations, and ethical standards governing healthcare operations
Healthcare compliance ensures organizations follow all applicable laws, regulations, and standards.
Question 2: What is the False Claims Act?
- A federal law imposing liability on those who submit fraudulent claims to government healthcare programs (Correct answer)
- A law about false advertising
- A law about identity theft
- A law about food labeling
Correct answer: A federal law imposing liability on those who submit fraudulent claims to government healthcare programs
The False Claims Act penalizes submitting knowingly false or fraudulent claims for payment to federal programs like Medicare.
Question 3: What is an audit trail in health information?
- A chronological record showing who accessed, modified, or deleted data and when (Correct answer)
- A hiking path through a hospital
- A financial spreadsheet
- A patient walking route
Correct answer: A chronological record showing who accessed, modified, or deleted data and when
Audit trails create accountability by tracking all interactions with health data.
Question 4: What is informed consent documentation?
- A record showing the patient was informed of risks, benefits, and alternatives before agreeing to treatment (Correct answer)
- A general hospital admission form
- A billing authorization
- An insurance application
Correct answer: A record showing the patient was informed of risks, benefits, and alternatives before agreeing to treatment
Informed consent documents demonstrate the patient received sufficient information to make a voluntary, knowledgeable decision about their care.
Question 5: What are accreditation requirements for health records?
- Standards set by organizations like The Joint Commission governing record content, timeliness, and completeness (Correct answer)
- Building codes
- Employee dress codes
- Parking regulations
Correct answer: Standards set by organizations like The Joint Commission governing record content, timeliness, and completeness
Accrediting bodies set minimum standards for documentation quality, completeness, and accessibility.
Question 6: What is a subpoena for health records?
- A legal order requiring the production of specified health records for legal proceedings (Correct answer)
- A prescription request
- A referral to a specialist
- An insurance authorization
Correct answer: A legal order requiring the production of specified health records for legal proceedings
A subpoena legally compels the release of specified records, but proper authorization and HIPAA compliance must still be verified.
AHIMA Compliance and Legal 1
What is healthcare compliance?