Compliance Puzzler

2. Clear, concise statements of the parameters by which AlohaCare conducts business
3. Develops and implements policies and procedures for compliance with HIPAA
4. Responsible for investigating and resolving FWA activity
6. One who reports unethical, illegal or inappropriate activity or misconduct
10. A nationally known accrediting body for health plans
12. Process of identifying and analyzing hazards or potential hazards
14. Practices that are inconsistent with sound fiscal business or medical practice
15. Overutilization of services that result in unnecessary costs
18. According to the rules or principles
19. Instructions or steps that describe how to complete a task or job
21. A false representation of fact by words or by conduct
22. the federal agency that provides health coverage to Medicare, Medicaid, the Children's Health Insurance Program, and the Health Insurance Marketplace
23. Health Insurance Portability and Accountability Act commonly known as

1. Potential clash between employee's self-interest, professional interest or public interest
5. stands for Quality care, Universal access, Efficient utilization, Stabilizing costs, and Transforming the way health care is provided to recipients
7. An adverse action against an employee for engaging in protected activity
8. Protected Health Information
9. AlohaCare's Compliance Officer is
11. Being in accordance with regulations, guidelines or specifications
13. Official examination and verification of accounts or records
16. Notice of Practices explains to members the uses and disclosures of PHI
17. Unauthorized access to a member's PHI
20. Measures taken to eliminate the causes of noncomliance