CHA Healthcare Auditor case studies
CHA Healthcare Auditor · Put your knowledge to work in context.
The Certified Healthcare Auditor (CHA) is a professional credential for auditors who examine the compliance, financial, and clinical operations of healthcare organizations. Candidates typically come from internal audit, revenue cycle and coding compliance, health information management, and regulatory compliance roles, and the credential signals that the holder can plan audits, gather and evaluate evidence, and report findings in a healthcare-specific regulatory context. The exam spans the full audit lifecycle applied to healthcare: the regulatory environment, professional standards and ethics, risk assessment and scoping, evidence and sampling, revenue cycle and billing/coding compliance, clinical documentation and quality review, HIPAA privacy and security, reporting and follow-up, and fraud, waste, and abuse investigation. Because the domains are weighted unevenly, preparation should follow the published blueprint rather than a generic auditing textbook. The CHA Healthcare Auditor case studies are 5 cases and about 1,951 words.
1Contradictory Documentation in Sepsis Coding
During a coding audit at a 350-bed hospital, you review 20 sepsis cases. In one case, the emergency department (ED) physician documents 'sepsis due to pneumonia' and orders antibiotics and fluids.
347 words, about 2 min2Sampling Methodology for Overpayment Audit
You are conducting a billing compliance audit for a multi-specialty clinic with 50,000 claims per year. The compliance committee is concerned about potential overpayments for evaluation and management (E/M) services.
362 words, about 2 min3HIPAA Privacy Breach Investigation
A patient complains that their neighbor, who works as a nurse at the hospital, accessed their electronic health record (EHR) without authorization. The patient discovered this because the nurse mentioned a recent lab result in casual conversation.
424 words, about 2 min4Fraud Risk in Home Health Billing
You are an external auditor engaged by a home health agency to review billing practices. The agency provides skilled nursing and therapy services to Medicare beneficiaries.
408 words, about 2 min5Quality-of-Care Audit in a Skilled Nursing Facility
As part of a quality-of-care audit at a skilled nursing facility (SNF), you review 30 residents' records for compliance with pressure ulcer prevention protocols. The facility's policy requires risk assessment using the Braden Scale upon admission and weekly, and repositioning every 2 hours for at-risk residents.
410 words, about 2 min