CODE OF BUSINESS CONDUCT COMPLIANCE AND ETHICS PROGRAM Knowledge Check Questions Compliance and Ethics Lesson 1 Knowledge Check Questions 1) According to the Coventry Code of Business Conduct and Ethics, outside jobs or activities could have a negative impact on your job performance and conflict with your responsibilities to Coventry. 2) A conflict of interest is any situation that may present itself as an opportunity for which of the following? (select one) A) receiving an individual spot bonus B) reporting financial misconduct C) receiving a quote from an outside vendor D) personal gain beyond benefits and salary 3) The Coventry Code of Business Conduct & Ethics is an official statement of how Coventry, its companies, and employees will do which of the following? (select one) A) quarterly earnings B) review compliance issues C) conducts its business D) submit federal documentation Compliance and Ethics Lesson 2 Knowledge Check Questions 4) Expense reports are also financial records. However, submission of inaccurate expenses will not result in disciplinary action and/or termination. 5) You may accept unsolicited, nonmonetary gifts worth less than $100 in a single calendar year from outside individuals or parties working with Coventry. 6) The Coventry Code of Business Conduct and Ethics requires accurate financial records. Which of the following is also considered a financial record? (select one) A) quarterly earnings B) timesheets C) sales quota Employee Development 2012 1
Compliance and Ethics Lesson 3 Knowledge Check Questions 7) Providing inaccurate, outdated, or misleading information whether intentionally or unintentionally, could subject you and Coventry to civil or criminal penalties. 8) It is illegal to give material non public information to anyone who might buy or sell Coventry stock. Compliance and Ethics Lesson 4 Knowledge Check Questions 9) The Code of Business Conduct and Ethics and the Reporting Potential Noncompliance policy require us to report which of the following? (select all that apply) A) suspected dishonest or illegal behavior B) actual dishonest or illegal behavior C) potential non compliance 10) Coventry's Record Retention and Destruction Policy was drafted to satisfy federal and state laws, and to reflect legal opinion. This policy applies to which of the following? (select one) A) all documents, regardless of whether they are paper or electronic B) only paper documents C) only electronic documents 11) Good faith reporting means that the individual has a reasonably held belief that the report is true and has not been made either for personal gain or for any ulterior motive. Employee Development 2012 2
Privacy and Security Lesson 1 Knowledge Check Questions 12) Match the following acronym with its title. Acronym Title HIPAA Health Information Technology HITECH Personal Identifiable Information PHI Health Insurance Portability and Accountability Act PII Protected Health Information 13) Under HIPAA, Coventry can disclose client PHI records to another Health Care Plan to ensure client treatment. 14) Which entities must comply with HIPAA and HITECH regulations? (select all that apply) A) Health Plans B) Clearing Houses C) Health Care Providers D) Business Associates 15) Business Associate must contractually agree to which of the following? (select one) A) protect against unauthorized use of disclosure of PHI B) protect medical personnel from lawsuits C) sell existing Coventry stock before becoming an associate Privacy and Security Lesson 2 Knowledge Check Questions 16) Deidentification is the removal of PHI/PII identifiers. 17) What client information is appropriate to be disclosed under the Privacy Rule pertaining to permitted uses or disclosures of PII/PHI? (select one) A) first line B) minimum necessary C) restricted 18) Social Security Numbers should be displayed as which of the following? (select one) A) the first four digits only B) the full number only C) the last four digits only Employee Development 2012 3
Privacy and Security Lesson 3 Knowledge Check Questions 19) Least privilege access means that we provide employees with access to which of the following? (select one) A) least possible amount of access/information to complete required job functions B) system that details employees on the least privilege list C) least privilege list of health care providers 20) Which of the following best completes this statement? Passwords should. (select one) A) only be shared with IT B) never be shared with anyone C) be easy to remember per or family names 21) Match the following Data Classification with the correct document type. Data Classification Document Type Trade Secret Information that is intended for use within Coventry Public Domain Disclosure of this information would have a significant negative impact and reduce client confidence Information that would have no adverse impact on company operations or liability Confidential Information that may be used by Coventry to establish a strategic advantage 22) Ensuring the privacy and security of our members information is every employee s responsibility. Privacy and Security Lesson 4 Knowledge Check Questions 23) Which of the following is an example of a security incident? (select one) A) Data that has been altered or destroyed outside of normal business practice. B) Significant changes to a file due to normal business practice. C) You forget your password. 24) Saving data to removable media will only be permitted using Coventry owned/purchased media. Employee Development 2012 4
Fraud, Waste, and Abuse Lesson 1 Knowledge Check Questions 25) Coventry will not tolerate fraud, waste or abuse in any of its relationships, and will as appropriate, identify, report, monitor and refer for prosecution situations of suspected fraud. 26) Match the term with the definition. Term Definition Fraud unintentionally providing information which results in unnecessary costs or payments Waste intentional deception resulting in unauthorized payment or benefit Abuse use of health care resources in an ineffective manner Fraud, Waste, and Abuse Lesson 2 Knowledge Check Questions 27) Doctor shopping (member/patient consulting a number of doctors to get multiple prescriptions) is fraud. 28) Of the following individuals, who could commit fraud, waste, and abuse in a health care system? (select all that apply) A) Member B) Provider C) Pharmacy D) Broker 29) Pharmacy fraud includes which of the following? (select all that apply) A) Billing for a brand name when dispensing a generic B) Altering the prescription without proper documentation C) Dispensing expired or adulterated prescription drugs 30) Managed Care Organization fraud or violations may include which of the following? (select all that apply) A) Use of deceptive or misleading marketing materials B) Engaging in discriminatory marketing and enrollment C) Submitting inaccurate data to the government for payment D) Formulary decisions where costs takes precedence over clinical effectiveness Fraud, Waste, and Abuse Lesson 3 Knowledge Check Questions 31) States may have their own fraud, waste, and abuse provisions that can be broader than the federal laws. 32) Fighting fraud, waste and abuse is a condition of Coventry s participation in government programs such as Medicare and Medicaid. Employee Development 2012 5