How should you process a back-dated enrollment application that violates operational guidelines?

Prepare for the AHIP Fraud, Waste, and Abuse Exam. Study with multiple choice questions, flashcards, hints, and detailed explanations. Boost your confidence and pass your exam!

Processing a back-dated enrollment application that violates operational guidelines requires adherence to compliance protocols. Submitting the application without changes while informing the compliance officer is the appropriate course of action, as it ensures that the situation is documented and managed according to the organization’s compliance framework.

This approach allows for transparency and accuracy in handling the application. By notifying the compliance officer, the organization can assess the implications of the back-dated enrollment and take necessary steps to rectify any procedural violations. This action also helps safeguard against potential legal or regulatory issues that may arise from improperly processing the enrollment.

Choosing to approve the application to avoid conflict, informing the supervisor without any further action, or solely discussing the issue with the beneficiary does not address the compliance aspect adequately. These options fail to uphold the necessary operational guidelines, which are designed to protect both the organization and the beneficiaries involved.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy