1Pass the CHC Exam With Ease
746.2 Common Fraud Schemes
2Preface
756.3 Case Study: Billing Fraud Scheme
3Chapter 1.0: Introduction to Healthcare Compliance
766.4 Billing Compliance Infrastructure
41.1 Understanding Healthcare Compliance
776.5 Physician Financial Arrangements
51.2 The CHC Certification
786.6 Marketing and Recruitment Compliance
61.3 Why Healthcare Compliance Matters Now
796.7 Case Study: Illegal Marketing Scheme
71.4 Case Study: The Cost of Noncompliance
806.8 Pharmaceutical Manufacturer Relationships
81.5 Career Benefits of CHC Certification
816.9 Internal Controls and Prevention
91.6 How to Use This Book
826.10 Bringing It Together
101.7 Study Timeline and Strategies
836.11 Practice Questions
111.8 Case Study: Certification as Career Catalyst
84Chapter 7.0: Investigations and Response
121.9 Key Concepts Review
857.1 Investigation Fundamentals
13Chapter 2.0: Healthcare Regulatory Landscape
867.2 Conducting Internal Investigations
142.1 HIPAA Privacy Rule Fundamentals
877.3 Interview Techniques
152.2 HIPAA Security Rule Requirements
887.4 Case Study: Investigation Failures
162.3 Business Associate Agreements
897.5 Mandatory Reporting Obligations
172.4 Breach Notification Requirements
907.6 Government Investigation Response
182.5 Case Study: HIPAA Breach Response Failure
917.7 Case Study: Strategic Investigation Response
192.6 Stark Law Fundamentals
927.8 Privilege Considerations
202.7 Stark Law Exceptions
937.9 Disciplinary Actions
212.8 Anti-Kickback Statute
947.10 Self-Disclosure and CIAs
222.9 Anti-Kickback Safe Harbors
957.11 Case Study: Successful Self-Disclosure
232.10 Case Study: Stark Law and AKS Violation
967.12 Key Concepts Review
242.11 False Claims Act
977.13 Practice Questions
252.12 Qui Tam Whistleblower Provisions
98Chapter 8.0: Training and Compliance Culture
262.13 Medicare and Medicaid Billing Compliance
998.1 Training Program Design
272.14 Key Enforcement Agencies
1008.2 Annual General Training
282.15 Chapter Summary
1018.3 Specialized High-Risk Training
292.16 Practice Questions
1028.4 Case Study: Training Transforms Culture
30Chapter 3.0: Building Effective Compliance Programs
1038.5 New Employee Onboarding
313.1 Seven Elements Overview
1048.6 Measuring Training Effectiveness
323.2 Written Policies and Procedures
1058.7 Creating Compliance Culture
333.3 Case Study: Policy Failures
1068.8 Hotline Management
343.4 Compliance Officer Role
1078.9 Whistleblower Protections
353.5 Compliance Committee Structure
1088.10 Case Study: Retaliation Backlash
363.6 Code of Conduct Development
1098.11 Summary and Applications
373.7 Case Study: Compliance Committee Effectiveness
1108.12 Practice Questions
383.8 Integration with Other Functions
111Chapter 9.0: Specialized Compliance Areas
393.9 Resource Allocation and Budgeting
1129.1 Research Compliance Fundamentals
403.10 Board Oversight and Governance
1139.2 Tax-Exempt Organization Compliance
413.11 Chapter Summary
1149.3 Case Study: Community Benefit Failure
42Chapter 4.0: Risk Assessment and Auditing
1159.4 Antitrust Considerations
434.1 Risk Assessment Fundamentals
1169.5 Environmental Compliance
444.2 Conducting Comprehensive Assessments
1179.6 Employment Law Intersection
454.3 Case Study: Risk Assessment Failure
1189.7 Medical Staff Credentialing
464.4 Audit Planning and Methodology
1199.8 Case Study: Credentialing Failure
474.5 Audit Execution and Findings
1209.9 Vendor and Supply Chain Compliance
484.6 Monitoring Strategies
1219.10 International Compliance
494.7 Data Analytics Applications
1229.11 Chapter Overview
504.8 Case Study: Analytics Success
1239.12 Practice Questions
514.9 Documentation and Work Papers
124Chapter 10.0: Exam Preparation Strategies
524.10 Remediation and Corrective Actions
12510.1 Understanding the Exam
534.11 Third-Party Vendor Oversight
12610.2 Strategic Test Taking
544.12 Case Study: Vendor Oversight Failure
12710.3 Time Management Methods
554.13 Essential Takeaways
12810.4 Question Structure Patterns
564.14 Practice Questions
12910.5 Case Study: Successful Exam Preparation
57Chapter 5.0: Privacy and Data Security
13010.6 Practice Question Analysis
585.1 HIPAA Privacy Rule Advanced Concepts
13110.7 Performance Assessment Methods
595.2 Uses and Disclosures Advanced Analysis
13210.8 Final Week Preparation
605.3 Case Study: Privacy Rule Misapplication
13310.9 Quick Reference Materials
615.4 Security Rule Administrative Safeguards
13410.10 Case Study: Overcoming Test Anxiety
625.5 Physical and Technical Safeguards
13510.11 Continued Learning Paths
635.6 State Privacy Laws
13610.12 Bringing It Together
645.7 Case Study: State Law Noncompliance
137Chapter 11:Practice Exam 1
655.8 Cybersecurity Threats
138Chapter 12: Practice Exam 2
665.9 Breach Response Protocol
139Chapter 13:Practice Exam 3
675.10 Business Associate Management
140Chapter 14: Practice Exam 4
685.11 Patient Rights and Requests
141Chapter 15 Practice Exam 5
695.12 Integration and Synthesis
142Chapter 16:Practice Exam 6
705.13 Chapter Summary
143Chapter 17:Practice Exam 7
715.14 Practice Questions
144Chapter 18:Practice Exam 8
72Chapter 6.0: Fraud Prevention Strategies
145References
736.1 Defining Fraud, Waste, and Abuse
