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ACFE Certified Fraud Examiner - Financial Transactions and Fraud Schemes Exam Sample Questions (Q179-Q184):
NEW QUESTION # 179
Which of the following items do NOT appear on the balance sheet?
- A. Owners' equity
- B. Expenses
- C. Liabilities
- D. Assets
Answer: B
NEW QUESTION # 180
Which of the following scenarios is an example of upcoding?
- A. Dr. Catz spends 15 minutes with a patient. She later submits a bill to the patient's insurance company using a code that corresponds to an office visit lasting 60 minutes.
- B. Hope is diagnosed with an ear infection. Hope's doctor writes her a prescription for a name brand medication instead of prescribing a less expensive generic medication.
- C. Steven receives medical services prior to his new insurance going into effect. Before submitting the claim, he changes the service date on his bill so that it will be covered by insurance.
- D. Dr. Smith performed a hysterectomy on Roberta. Dr. Smith submits an insurance claim using three procedure codes instead of the single code normally used for a hysterectomy.
Answer: A
NEW QUESTION # 181
To detect health care provider fraud, a fraud examiner should be alert for which of the following red flags?
- A. Unusually low profits compared to similar businesses in the same region
- B. Consistently low percentage of coding outliers present
- C. Lack of supporting documentation for claims under review
- D. Details in supporting documentation that match the health care claim
Answer: C
Explanation:
Explanation/Reference: https://www.acfe.com/uploadedfiles/acfe_website/content/documents/insurance-fraud-handbook.pdf (18)
NEW QUESTION # 182
By what accountant means that the financial figures presented by the company are at least as much as reflected in the statements, if not more.
- A. Matching
- B. Fraudulent statement
- C. Conservatism
- D. Misappropriations
Answer: C
NEW QUESTION # 183
Which of the following can constitute a bribe, even if the illicit payment is never actually made?
- A. Corruption in payment
- B. kickback payment
- C. Overbilling in payment
- D. Offering a payment
Answer: D
NEW QUESTION # 184
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