CHC (AHE) 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 health care organizations - hospitals, physician groups, health plans, pharmacies, device and life-science companies, and the vendors that serve them. It signals that the holder understands how a compliance program is structured and how it operates day to day, not just that they can recite regulations. The CHC study guide has 9 sections and about 2,679 words.
01Standards, Policies, and Procedures
A compliance program is built in layers. Standards of conduct are the organization's broad ethical commitments (e.g., "we bill only for services actually provided").
352 words, about 2 min02Compliance Program Administration and Infrastructure
Compliance program infrastructure maps to the recognized program elements: written standards, a compliance officer and committee, effective training and education, open lines of communication, internal monitoring and auditing, enforcement and discipline, and response and prevention. Administration is about who owns these, how they are resourced, and how they connect.
332 words, about 2 min03Education and Training
Training builds specific, role-based skills (how to code a claim, how to report a concern); education builds general awareness (why integrity matters). Effective programs do both and target content to the audience - general workforce, high-risk roles, and leadership each need different depth.
307 words, about 2 min04Monitoring, Auditing, and Internal Investigations
Monitoring is ongoing, routine oversight (e.g., monthly pre-bill reviews, manager spot checks). Auditing is periodic, independent, systematic review against defined criteria (e.g., an annual coding audit of a sample of claims).
278 words, about 1 min05Enforcement, Discipline, and Corrective Action
Discipline demonstrates that standards matter. Enforcement should be consistent, documented, and proportionate to the violation, applied regardless of seniority.
296 words, about 1 min06Regulatory and Legal Requirements
Candidates should understand the purpose and basic mechanics of major healthcare compliance laws. The Anti-Kickback Statute (AKS) prohibits knowingly offering or receiving remuneration to induce referrals of items or services payable by federal healthcare programs; it is intent-based and has safe harbors.
307 words, about 2 min07Risk Assessment, Detection, and Reporting
A risk assessment identifies, ranks, and prioritizes compliance risks so resources go where exposure is greatest. Typical steps: inventory risks, rate likelihood and impact, consider regulatory change and prior findings, and produce a documented ranking that drives the work plan.
271 words, about 1 min08Communication, Culture, and Governance
The governing body and senior leaders set the tone at the top ; managers set the tone in the middle. Culture is how people actually behave when no one is watching.
278 words, about 1 min09Program Effectiveness and Continuous Improvement
An effective program is more than a set of documents; it changes behavior and reduces risk. Effectiveness is measured with a mix of inputs, outputs, and outcomes: training completion (output), audit findings and trends (outcome), hotline volume and substantiation, investigation cycle times, corrective-action closure rates, and culture surveys.
258 words, about 1 min