CHAA CORE MAIN QUESTIONS AND ANSWERS SET
A+
✔✔What does the term 'ePHI' stand for? - ✔✔Electronic Protected Health Information.
✔✔What is the role of the National Institute of Standards and Technology (NIST)
regarding ePHI? - ✔✔To provide organizations with detailed security guidance to help
protect ePHI.
✔✔What type of information is included in personally identifiable information (PII)? -
✔✔Patient names, addresses, Social Security numbers, and other identifiers that can
identify an individual.
✔✔What happens if a patient requests a copy of their PHI? - ✔✔They cannot be
charged more than a reasonable labor cost for copying the PHI and may not be charged
a retrieval fee.
✔✔What is the significance of the 'Restricted Disclosure' right? - ✔✔It allows a patient
to request that a healthcare organization not disclose medical information to their
insurance company.
✔✔What are the consequences of failing to properly note a patient's wishes regarding
PHI? - ✔✔It can have extremely negative consequences for both the patient and the
healthcare organization.
✔✔What is one way Patient Access professionals can protect cardholder information? -
✔✔Never copy a patient's credit card.
✔✔What does Medicare provide health insurance for? - ✔✔Over 55 million people,
primarily those aged 65 or older and younger people with disabilities.
, ✔✔What is the purpose of the Meaningful Use (MU) program? - ✔✔To provide
monetary incentives for the adoption and meaningful use of health information
technology and qualified electronic health records (EHR).
✔✔What are the goals of Meaningful Use technology? - ✔✔Improve quality, safety,
efficiency, engage patients and family, improve care coordination, and maintain privacy
and security.
✔✔What is the Two-Midnight Rule in Medicare? - ✔✔Inpatient stays must cross two
midnights to be reimbursable under Medicare Part A; stays less than two midnights are
reimbursed under Part B.
✔✔What is Condition Code 44? - ✔✔A code used when a Medicare patient is changed
from inpatient to observation status after an internal review.
✔✔What must happen for a change from inpatient to observation status to be
permissible? - ✔✔The change must be made prior to discharge, no claim for inpatient
admission submitted, and documented physician agreement.
✔✔What does the Important Message from Medicare (IMM) explain? - ✔✔It explains
patients' rights as hospital patients and what to do if they feel they are being discharged
early.
✔✔What is the Medicare Outpatient Observation Notice (MOON)? - ✔✔A form given to
Medicare beneficiaries to inform them of their outpatient observation status and its
financial implications.
✔✔What is the purpose of the Medicare Secondary Payer (MSP) questionnaire? -
✔✔To determine if there are other payers that may pay primary to Medicare.
✔✔How often must the MSP questionnaire be completed? - ✔✔Each time a service is
provided to Medicare Original patients.
✔✔What is defined as 'medically necessary' by Medicare? - ✔✔Healthcare services or
supplies needed to prevent, diagnose, or treat an illness, injury, or condition that meet
accepted standards of medicine.
✔✔What happens if a service does not meet Medicare's standards of medical
necessity? - ✔✔An Advance Beneficiary Notice (ABN) is presented to the patient,
informing them of possible non-coverage.
✔✔What is the role of Patient Access professionals regarding medical necessity
checks? - ✔✔They often run checks using software that accesses the Medicare Medical
Necessity Database.
A+
✔✔What does the term 'ePHI' stand for? - ✔✔Electronic Protected Health Information.
✔✔What is the role of the National Institute of Standards and Technology (NIST)
regarding ePHI? - ✔✔To provide organizations with detailed security guidance to help
protect ePHI.
✔✔What type of information is included in personally identifiable information (PII)? -
✔✔Patient names, addresses, Social Security numbers, and other identifiers that can
identify an individual.
✔✔What happens if a patient requests a copy of their PHI? - ✔✔They cannot be
charged more than a reasonable labor cost for copying the PHI and may not be charged
a retrieval fee.
✔✔What is the significance of the 'Restricted Disclosure' right? - ✔✔It allows a patient
to request that a healthcare organization not disclose medical information to their
insurance company.
✔✔What are the consequences of failing to properly note a patient's wishes regarding
PHI? - ✔✔It can have extremely negative consequences for both the patient and the
healthcare organization.
✔✔What is one way Patient Access professionals can protect cardholder information? -
✔✔Never copy a patient's credit card.
✔✔What does Medicare provide health insurance for? - ✔✔Over 55 million people,
primarily those aged 65 or older and younger people with disabilities.
, ✔✔What is the purpose of the Meaningful Use (MU) program? - ✔✔To provide
monetary incentives for the adoption and meaningful use of health information
technology and qualified electronic health records (EHR).
✔✔What are the goals of Meaningful Use technology? - ✔✔Improve quality, safety,
efficiency, engage patients and family, improve care coordination, and maintain privacy
and security.
✔✔What is the Two-Midnight Rule in Medicare? - ✔✔Inpatient stays must cross two
midnights to be reimbursable under Medicare Part A; stays less than two midnights are
reimbursed under Part B.
✔✔What is Condition Code 44? - ✔✔A code used when a Medicare patient is changed
from inpatient to observation status after an internal review.
✔✔What must happen for a change from inpatient to observation status to be
permissible? - ✔✔The change must be made prior to discharge, no claim for inpatient
admission submitted, and documented physician agreement.
✔✔What does the Important Message from Medicare (IMM) explain? - ✔✔It explains
patients' rights as hospital patients and what to do if they feel they are being discharged
early.
✔✔What is the Medicare Outpatient Observation Notice (MOON)? - ✔✔A form given to
Medicare beneficiaries to inform them of their outpatient observation status and its
financial implications.
✔✔What is the purpose of the Medicare Secondary Payer (MSP) questionnaire? -
✔✔To determine if there are other payers that may pay primary to Medicare.
✔✔How often must the MSP questionnaire be completed? - ✔✔Each time a service is
provided to Medicare Original patients.
✔✔What is defined as 'medically necessary' by Medicare? - ✔✔Healthcare services or
supplies needed to prevent, diagnose, or treat an illness, injury, or condition that meet
accepted standards of medicine.
✔✔What happens if a service does not meet Medicare's standards of medical
necessity? - ✔✔An Advance Beneficiary Notice (ABN) is presented to the patient,
informing them of possible non-coverage.
✔✔What is the role of Patient Access professionals regarding medical necessity
checks? - ✔✔They often run checks using software that accesses the Medicare Medical
Necessity Database.
