Certified in Healthcare Compliance (CHC) 2025 – 400 Free Practice Questions to Pass the Exam

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According to the OIG, which of the following would likely be the least helpful measure for improving outpatient services?

Describe the hospital's post-submission testing process to a fiscal intermediary

Describing the hospital's post-submission testing process to a fiscal intermediary is likely the least helpful measure for improving outpatient services according to the OIG's guidelines. While communication with a fiscal intermediary can provide insight and foster relationships, this action primarily serves as an explanation of the hospital's processes rather than a proactive measure aimed at enhancing the quality or efficiency of outpatient services.

In contrast, evaluating all possible bills for outpatient services involves a comprehensive review of the billing process, which can uncover discrepancies and ensure appropriate charges. Implementing computer programs to identify outpatient services that are not billed separately from inpatient services directly targets billing issues and helps to maximize proper reimbursement. Establishing a regular manual review of outpatient service claims provides an additional layer of oversight, allowing for the identification and correction of errors in claims before submission to ensure compliance and accuracy in billing.

Together, these options actively engage in quality improvement and compliance, while merely describing existing processes does not contribute effectively to the enhancement of outpatient services. Thus, it is clear why the selected answer is deemed less impactful in this context.

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Evaluate all possible bills for outpatient services

Implement computer programs to identify outpatient services that are not billed separately from inpatient services

Establish a regular manual review of outpatient service claims

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