CHAA REVIEW TIPS QUESTIONS AND ANSWERS SET
A+
✔✔What is the role of Medicare contractors in fraud prevention? - ✔✔They routinely
screen claims and employ fraud investigators.
✔✔What does the term 'misusing codes' refer to in healthcare billing? - ✔✔Using
incorrect codes on claims, such as upcoding or unbundling services.
✔✔What is the tagline of the organization discussed? - ✔✔Safer, Smarter, Greener.
✔✔What does AAAHC stand for? - ✔✔Accreditation Association for Ambulatory Health
Care.
✔✔What types of organizations does AAAHC accredit? - ✔✔Ambulatory surgery
centers, office-based surgery centers, endoscopy centers, and college student health
centers.
✔✔What is Medicaid? - ✔✔A joint federal and state program that provides health
coverage to over 72.5 million Americans.
✔✔Who are the mandatory eligibility groups for Medicaid? - ✔✔Low-income families,
transitional medical assistance, qualified pregnant women and children, individuals
receiving SSI, elderly, blind and disabled, low-income Medicare beneficiaries.
✔✔What is MAGI? - ✔✔Modified Adjusted Gross Income, a methodology used to
determine income eligibility based on taxable income.
✔✔What is Presumptive Eligibility in Medicaid? - ✔✔A process where hospitals and
qualified physicians can screen patients for temporary Medicaid coverage based on
self-attested answers.
, ✔✔What is TRICARE? - ✔✔A healthcare program for military active duty members,
reservists, retirees, and their families.
✔✔What are the different health plans offered by TRICARE? - ✔✔TRICARE Prime,
TRICARE Standard, TRICARE Select, and TRICARE for Life.
✔✔What is CHAMPVA? - ✔✔The Civilian Health and Medical Program for the Veterans
Administration, providing insurance for families of veterans.
✔✔What is the eligibility requirement for CHAMPVA? - ✔✔Spouses or children of
veterans rated permanently and totally disabled for a service-connected disability.
✔✔What is the Veterans Health Administration? - ✔✔The largest integrated healthcare
system in America, serving almost 9 million veterans each year.
✔✔What is the CMS rule regarding inpatient stays for Medicare Part A? - ✔✔The
Medicare Two-midnight rule states that an inpatient stay must cross two midnights to be
paid for under Medicare Part A.
✔✔What is the role of CMS? - ✔✔To protect the integrity of the Hospital and Human
Services (HHS) program by detecting and preventing fraud.
✔✔What is EMTALA? - ✔✔A regulation that protects patients from being untreated in
an emergency due to lack of ability to pay.
✔✔What does Meaningful Use aim to achieve? - ✔✔To increase the adoption of
qualified electronic health records.
✔✔What document is provided to Medicare beneficiaries in outpatient observation
status? - ✔✔MOON (Medicare Outpatient Observation Notice).
✔✔What is an example of fraud in healthcare? - ✔✔Billing for services not rendered.
✔✔What is the significance of the Affordable Care Act for Medicaid? - ✔✔It allowed
states to expand Medicaid by raising the federal poverty level to 133 percent for children
and adults.
✔✔What is the primary function of the Veterans Administration? - ✔✔To provide
healthcare services to veterans.
✔✔What is the role of Medicaid Coordination of Benefits? - ✔✔Medicaid is considered
the 'payer of last resort,' meaning all other insurance policies pay primary to Medicaid.
A+
✔✔What is the role of Medicare contractors in fraud prevention? - ✔✔They routinely
screen claims and employ fraud investigators.
✔✔What does the term 'misusing codes' refer to in healthcare billing? - ✔✔Using
incorrect codes on claims, such as upcoding or unbundling services.
✔✔What is the tagline of the organization discussed? - ✔✔Safer, Smarter, Greener.
✔✔What does AAAHC stand for? - ✔✔Accreditation Association for Ambulatory Health
Care.
✔✔What types of organizations does AAAHC accredit? - ✔✔Ambulatory surgery
centers, office-based surgery centers, endoscopy centers, and college student health
centers.
✔✔What is Medicaid? - ✔✔A joint federal and state program that provides health
coverage to over 72.5 million Americans.
✔✔Who are the mandatory eligibility groups for Medicaid? - ✔✔Low-income families,
transitional medical assistance, qualified pregnant women and children, individuals
receiving SSI, elderly, blind and disabled, low-income Medicare beneficiaries.
✔✔What is MAGI? - ✔✔Modified Adjusted Gross Income, a methodology used to
determine income eligibility based on taxable income.
✔✔What is Presumptive Eligibility in Medicaid? - ✔✔A process where hospitals and
qualified physicians can screen patients for temporary Medicaid coverage based on
self-attested answers.
, ✔✔What is TRICARE? - ✔✔A healthcare program for military active duty members,
reservists, retirees, and their families.
✔✔What are the different health plans offered by TRICARE? - ✔✔TRICARE Prime,
TRICARE Standard, TRICARE Select, and TRICARE for Life.
✔✔What is CHAMPVA? - ✔✔The Civilian Health and Medical Program for the Veterans
Administration, providing insurance for families of veterans.
✔✔What is the eligibility requirement for CHAMPVA? - ✔✔Spouses or children of
veterans rated permanently and totally disabled for a service-connected disability.
✔✔What is the Veterans Health Administration? - ✔✔The largest integrated healthcare
system in America, serving almost 9 million veterans each year.
✔✔What is the CMS rule regarding inpatient stays for Medicare Part A? - ✔✔The
Medicare Two-midnight rule states that an inpatient stay must cross two midnights to be
paid for under Medicare Part A.
✔✔What is the role of CMS? - ✔✔To protect the integrity of the Hospital and Human
Services (HHS) program by detecting and preventing fraud.
✔✔What is EMTALA? - ✔✔A regulation that protects patients from being untreated in
an emergency due to lack of ability to pay.
✔✔What does Meaningful Use aim to achieve? - ✔✔To increase the adoption of
qualified electronic health records.
✔✔What document is provided to Medicare beneficiaries in outpatient observation
status? - ✔✔MOON (Medicare Outpatient Observation Notice).
✔✔What is an example of fraud in healthcare? - ✔✔Billing for services not rendered.
✔✔What is the significance of the Affordable Care Act for Medicaid? - ✔✔It allowed
states to expand Medicaid by raising the federal poverty level to 133 percent for children
and adults.
✔✔What is the primary function of the Veterans Administration? - ✔✔To provide
healthcare services to veterans.
✔✔What is the role of Medicaid Coordination of Benefits? - ✔✔Medicaid is considered
the 'payer of last resort,' meaning all other insurance policies pay primary to Medicaid.
