CHC (CCB) study guide
CHC · Work through your exam, one topic at a time.
The Certified in Healthcare Compliance (CHC) credential is a professional certification for people who build, run, or work inside compliance programs in healthcare organizations - hospitals, physician groups, payers, pharmacies, device and lab companies, and the vendors that serve them. It signals that the holder understands how a compliance program is designed and operated day to day, not just how to read a regulation. The CHC study guide has 8 sections and about 2,766 words.
01Standards, Policies, and Procedures
You must distinguish a standard (a mandatory statement of what must be achieved, often tied to an external authority such as a regulation or accreditation condition) from a policy (management's written position on how the organization will meet the standard) and a procedure (the step-by-step how , usually operational and role-specific). Questions love to blur these lines.
412 words, about 2 min02Compliance Program Administration
Administration is the machinery: governance, structure, authority, resources, and documentation. Know the seven elements framework that underlies most healthcare compliance programs: written standards and procedures; designated compliance officer and compliance committee; effective training and education; effective lines of communication; internal monitoring and auditing; enforcement through well-publicized disciplinary guidelines; and prompt response to detected problems with corrective action.
359 words, about 2 min03Education and Training
Training is the seventh-element cousin of communication: it must be effective , not merely delivered. Know the components of an effective program: needs assessment by role and risk, role-tailored content, qualified instructors or validated modules, documented completion, comprehension verification, and periodic refresh with updates when rules or risks change.
330 words, about 2 min04Communication and Reporting
An effective program needs lines of communication in both directions: leadership-to-workforce (standards, expectations, updates) and workforce-to-leadership (questions, concerns, reports of suspected wrongdoing). Know the design features of a reporting system: multiple channels (hotline, web, direct to compliance, supervisor), anonymity and confidentiality where permitted, non-retaliation, triage and tracking, and feedback to the reporter where feasible.
339 words, about 2 min05Monitoring, Auditing, and Internal Review
Distinguish monitoring (ongoing, routine, often real-time checks built into workflows) from auditing (periodic, independent, systematic examination against criteria). Know the audit lifecycle: scope and objective, risk-based sampling, criteria, data collection, analysis, findings, reporting, corrective action, and follow-up/re-audit.
310 words, about 2 min06Enforcement and Investigation
When a concern arises, the program must respond promptly, consistently, and documented . Know the investigation lifecycle: intake and triage, conflict check, investigation plan, evidence collection and preservation, interviews, analysis, determination, corrective action, discipline, and closure with documentation.
330 words, about 2 min07Risk Assessment and Management
Risk assessment is the engine that prioritizes everything else. Know a repeatable process: identify risks (regulatory change, billing patterns, privacy incidents, referral relationships, vendor access), assess likelihood and impact , score and rank, map to controls, assign owners, and monitor.
329 words, about 2 min08Regulatory and Legal Requirements (Fraud and Abuse, Privacy, Coding/Billing)
Know the core federal frameworks at a conceptual level. False Claims Act: prohibits knowingly presenting false claims; includes qui tam relators and treble damages plus per-claim penalties; "knowingly" includes deliberate ignorance and reckless disregard.
357 words, about 2 min