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ACFE Certified Fraud Examiner -Fraud Schemes and Financial Crimes Sample Questions:

1. Which of the following statements is MOST ACCURATE?

A) Government and public sector organizations have more autonomy in how they practice fraud detection than private sector organizations.
B) Government and public sector organizations can usually accept more fraud risk than private sector organizations because there are no shareholders.
C) Government and public sector organizations are required to reprioritize areas of focus for fraud detection less frequently than private sector organizations.
D) Government and public sector organizations might need to conduct and respond to fraud risk assessments more frequently than private sector organizations.

2. Which of the following scenarios is an example of upcoding?

A) 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.
B) 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.
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.

3. Skylar messages Timothy on a social media platform even though they have never met and expresses romantic interest. When Timothy responds, Skylar asks him to move the conversation to an outside messaging platform, and they develop a romantic relationship over several months through their communications. During this time, Skylar never requests that Timothy send her money or items of value, but she does convince him to make several large purchases of cryptocurrencies through a new cryptocurrency exchange. When Timothy tries to sell the cryptocurrency at a profit and withdraw his funds, Skylar stops responding to his messages, and he discovers the cryptocurrency exchange did not actually exist. Timothy is a victim of:

A) A pump-and-dump scheme
B) A pig butchering scheme
C) An advance-fee scheme
D) A Ponzi scheme

4. Mario performs surgery on a patient to replace a bone. The surgery should be billed using one code, but Mario bills the surgery using three codes (one for the entire surgery, one for the removal of the bone, and another for the insertion of the artificial bone), which increases the cost. Which of the following BEST describes Mario's scheme?

A) Unbundling
B) Fictitious services
C) Upcoding
D) False diagnosis

5. A journal in which all sales made on credit or cash are listed is:

A) Accounts payable journal
B) Accounts receivable journal
C) General journal
D) Disbursement journal

Solutions: