AACE CCT PRIMER SCRIPT 2026
AUTHENTIC QUESTIONS AND FULL
SOLUTIONS COMPLETE STUDY MATERIAL
GRADED A+
⩥Abuse.
Answer: coding practices that lead to improper reimbursement by error
because they do not meet medical necessity, ex. changing diagnosis to be
covered by insurance
⩥Accreditation.
Answer: an examination process the healthcare facility goes through to
evaluate the facilities policies, procedures, and performance to meet
higher standards.
⩥Accredited.
Answer: Having seal of approval after being evaluated and
demonstrating quality standards
⩥Act/ Law/ Statute.
Answer: Legislation passed through Congress and signed by President or
passed over his veto
,⩥Actual Charge.
Answer: The amount the provider charges for medical services or
supplies. Not always paid in full.
⩥Additional Benefits.
Answer: Health care services not covered by Medicare and are offered
through the Medicare Advantage Organization for no additional
premium. The benefits must equal the ACR (Adjusted Community
Rating)
⩥Adjudication.
Answer: Health Insurance Claims process at the insurance company
⩥Adjusted Average Per Capita Cost (AAPCC).
Answer: Estimate of how much Medicare will spend in a year for an
average beneficiary
⩥Administrative Code Sets.
Answer: Non medical code sets that characterize a general business
situation rather than a medical condition.
⩥Administrative Costs.
Answer: Medicare, Medicaid, CMS refer to this as their expenses to
have the program, operating expenses, program management, etc.
, ⩥Administrative Data.
Answer: Health insurance information stored in automated information
system about enrollment, eligibility, claims, etc.
⩥Administrative Law Judge (ALJ).
Answer: hearing officer who presides over appeal conflicts between
providers or beneficiaries, and Medicare contractors (MAC's)
⩥Administrative Simplification.
Answer: Part of HIPAA authorizing HHS (Health and Human Services)
to 1. adopt standards for transactions & code sets; 2. adopt standard
identifiers for health plans; 3. adopt standards to protect security &
privacy of personally identifiable health information.
⩥Administrative Simplification Act.
Answer: Signed 12/17/01 allows HHS (Health & Human Services) to
exclude providers from Medicare for HIPAA non-compliance of
electronic claims and prohibit paper claims except in certain situations
⩥Admission Date.
Answer: The date the patient was admitted for inpatient care, outpatient,
or start of care.For hospice, enter effective date of election of hospice
benefits.
AUTHENTIC QUESTIONS AND FULL
SOLUTIONS COMPLETE STUDY MATERIAL
GRADED A+
⩥Abuse.
Answer: coding practices that lead to improper reimbursement by error
because they do not meet medical necessity, ex. changing diagnosis to be
covered by insurance
⩥Accreditation.
Answer: an examination process the healthcare facility goes through to
evaluate the facilities policies, procedures, and performance to meet
higher standards.
⩥Accredited.
Answer: Having seal of approval after being evaluated and
demonstrating quality standards
⩥Act/ Law/ Statute.
Answer: Legislation passed through Congress and signed by President or
passed over his veto
,⩥Actual Charge.
Answer: The amount the provider charges for medical services or
supplies. Not always paid in full.
⩥Additional Benefits.
Answer: Health care services not covered by Medicare and are offered
through the Medicare Advantage Organization for no additional
premium. The benefits must equal the ACR (Adjusted Community
Rating)
⩥Adjudication.
Answer: Health Insurance Claims process at the insurance company
⩥Adjusted Average Per Capita Cost (AAPCC).
Answer: Estimate of how much Medicare will spend in a year for an
average beneficiary
⩥Administrative Code Sets.
Answer: Non medical code sets that characterize a general business
situation rather than a medical condition.
⩥Administrative Costs.
Answer: Medicare, Medicaid, CMS refer to this as their expenses to
have the program, operating expenses, program management, etc.
, ⩥Administrative Data.
Answer: Health insurance information stored in automated information
system about enrollment, eligibility, claims, etc.
⩥Administrative Law Judge (ALJ).
Answer: hearing officer who presides over appeal conflicts between
providers or beneficiaries, and Medicare contractors (MAC's)
⩥Administrative Simplification.
Answer: Part of HIPAA authorizing HHS (Health and Human Services)
to 1. adopt standards for transactions & code sets; 2. adopt standard
identifiers for health plans; 3. adopt standards to protect security &
privacy of personally identifiable health information.
⩥Administrative Simplification Act.
Answer: Signed 12/17/01 allows HHS (Health & Human Services) to
exclude providers from Medicare for HIPAA non-compliance of
electronic claims and prohibit paper claims except in certain situations
⩥Admission Date.
Answer: The date the patient was admitted for inpatient care, outpatient,
or start of care.For hospice, enter effective date of election of hospice
benefits.
