CHAA CORRECT EXAMS QUESTIONS AND ANSWERS
SET A+
✔✔What can PAFS do to protect PHI? - ✔✔-Interview the patient in private whenever
possible
-Never discuss patient information in public
-Lock your computer when you step away from your desk
-Be sure all mobile devices are secure
-Have computer screens facing away from public view
-Never throw items containing PHI in the trash; use reciprocals dedicated to secure
shredding/recycling
-Never share your passwords with anyone
-Never let someone use your computer while you are signed on
-Never look up a patient's information because you can, only when your role dictates the
use of patient information
✔✔PCI DSS - ✔✔Payment Card Industry Data Security Standard (PCI DSS)
It is required for any Patient Access professional who handles point-of-service payment
collections to follow PCI standards. Any organization that handles branded credit cards,
such as Visa, MasterCard, American Express and Discover, is responsible for
maintaining the security of all cardholder data.
✔✔What are some ways that PAFS can protect cardholder information? - ✔✔-Never
copy a patient's credit card
-Obtain and enter the credit card information in a private place
-Only use encrypted devices
-Never write down card holder data
-Remove all receipts from the printer promptly
✔✔What is the goal of providing MU Technology? - ✔✔-Improve quality, safety and
efficiency, and reduce health disparities
-Engage patients and family
-Improve care coordination and population and public health
,-Maintain privacy and security of patient health information
✔✔The change from Inpatient to OBS is permissible, but only if all of the following
conditions are met: - ✔✔-The change in patient status from inpatient to outpatient
(observation) is made prior to discharge or release while the member is still a patient of
the hospital;
-The hospital has not submitted a claim for inpatient admission;
-A physician concurs with the utilization review committee's decision;
-The physician and utilization review committee's decision is documented in the
patient's medical record; and
-The medical record should contain orders and notes that indicate why the change was
made and that the care was furnished to the member and the participants making this
decision, in order to change the status.
✔✔Medicare Retirement Date Requirements and guidelines: - ✔✔Medicare requires
that a beneficiary's retirement dates be recorded in the MSP. This question is used to
help determine coverage with group health plans. If the beneficiary is unable to
remember their retirement dates, Medicare offers the following guidelines:
1. If the beneficiary retired prior to the Medicare A entitlement date on their card, use
the entitlement date.
2. If the beneficiary is dependent under their spouse's group health plan and the spouse
retired prior to the beneficiary's Medicare A entitlement date, use the patient's Medicare
entitlement date.
3. If the beneficiary worked beyond their Medicare A entitlement date and it has been at
least five years since they retired, enter the date of service five years ago.
4. If the retirement date occurred less than five years ago, the hospital must obtain the
retirement dates from other resources.
✔✔What constitutes a recurring visit? How often do you need to verify MSP's? - ✔✔Per
CMS regulations, for recurring visits (where one account is created and the patient has
several recurring visits for the same service, such as physical therapy, all charges for
each visit are entered into the one account), you are required to verify the patient's MSP
information every 90 days to ensure the information is current and updated as needed.
✔✔Pt is 65+ and covered by a GHP through current employment or spouce's current
employment.
The individual is entitled to medicare.
The employer has less than 20 employees.
What is the order of coverage? - ✔✔1st Medicare
2nd GHP
,✔✔Pt is 65+ and covered by a GHP through current employment or spouce's current
employment.
The individual is entitled to medicare.
The employer has 20 or more employees, or the employer is part of a multi-employer
group with at least one employer employing 20 or more individuals.
What is the order of coverage? - ✔✔1st GHP
2nd Medicare
✔✔Pt is 65+ and covered by a retirement GHP, not working.
The individual is entitled to medicare.
What is the order of coverage? - ✔✔1st Medicare
2nd Retiree Coverage
✔✔Pt under age 65 and didabled, covered by GHP through current employment or
through family members current employment.
The individual is entitled to medicare.
The employer has less than 100 employees.
What is the order of coverage? - ✔✔1st Medicare
2nd GHP
✔✔Pt is under 65 and disabled. Covered by a GHP through current employment or
family current employment.
The individual is entitled to medicare.
The employer has 100 or more employees, or is part of a multi-employer group with at
least 1 having over 100 employees.
What is the order of coverage? - ✔✔1st GHP
2nd Medicare
✔✔Pt has ESRD and GHP coverage was the primary plan prior to the individual
becoming eligible and entitled to medicare based on ESRD.
First 30 months of medicare eligibility or entitlement.
What is the order of coverage? - ✔✔1st GHP
, 2nd Medicare
✔✔Pt has ESRD and GHP coverage.
After 30 months of medicare eligibility or entitlement.
What is the order of coverage? - ✔✔1st Medicare
2nd GHP
✔✔Has ESRD and COBRA coverage prior to becoming eligible or entitled to medicare.
First 30 months of medicare eligibility or entitlement.
What is the order of coverage? - ✔✔1st COBRA
2nd Medicare
✔✔COBRA - ✔✔Consolidated Omnibus Budget Reconciliation Act of 1985
✔✔Pt has ESRD and COBRA coverage.
After 30 months of medicare eligibility or entitlement.
What is the order of coverage? - ✔✔1st Medicare
2nd COBRA
✔✔Pt is covered under Workers Comp because of a job-related illness or injury.
The individual is entitled to medicare.
What is the order of coverage? - ✔✔1st WC for health care items or services related to
job-related illness or injury.
2nd Medicare
✔✔According to medicare, how much money was lost in 2015 due to fraud, waste,
abuse and improper payment? - ✔✔$60 billion
✔✔Fraud - ✔✔Fraud is the intentional deception or
misrepresentation.
✔✔Abuse - ✔✔Abuse is when healthcare providers unintentionally bill incorrectly,
causing unnecessary costs.
✔✔Examples of fraud and abuse: - ✔✔-Billing for services not rendered
-Billing for services multiple times
SET A+
✔✔What can PAFS do to protect PHI? - ✔✔-Interview the patient in private whenever
possible
-Never discuss patient information in public
-Lock your computer when you step away from your desk
-Be sure all mobile devices are secure
-Have computer screens facing away from public view
-Never throw items containing PHI in the trash; use reciprocals dedicated to secure
shredding/recycling
-Never share your passwords with anyone
-Never let someone use your computer while you are signed on
-Never look up a patient's information because you can, only when your role dictates the
use of patient information
✔✔PCI DSS - ✔✔Payment Card Industry Data Security Standard (PCI DSS)
It is required for any Patient Access professional who handles point-of-service payment
collections to follow PCI standards. Any organization that handles branded credit cards,
such as Visa, MasterCard, American Express and Discover, is responsible for
maintaining the security of all cardholder data.
✔✔What are some ways that PAFS can protect cardholder information? - ✔✔-Never
copy a patient's credit card
-Obtain and enter the credit card information in a private place
-Only use encrypted devices
-Never write down card holder data
-Remove all receipts from the printer promptly
✔✔What is the goal of providing MU Technology? - ✔✔-Improve quality, safety and
efficiency, and reduce health disparities
-Engage patients and family
-Improve care coordination and population and public health
,-Maintain privacy and security of patient health information
✔✔The change from Inpatient to OBS is permissible, but only if all of the following
conditions are met: - ✔✔-The change in patient status from inpatient to outpatient
(observation) is made prior to discharge or release while the member is still a patient of
the hospital;
-The hospital has not submitted a claim for inpatient admission;
-A physician concurs with the utilization review committee's decision;
-The physician and utilization review committee's decision is documented in the
patient's medical record; and
-The medical record should contain orders and notes that indicate why the change was
made and that the care was furnished to the member and the participants making this
decision, in order to change the status.
✔✔Medicare Retirement Date Requirements and guidelines: - ✔✔Medicare requires
that a beneficiary's retirement dates be recorded in the MSP. This question is used to
help determine coverage with group health plans. If the beneficiary is unable to
remember their retirement dates, Medicare offers the following guidelines:
1. If the beneficiary retired prior to the Medicare A entitlement date on their card, use
the entitlement date.
2. If the beneficiary is dependent under their spouse's group health plan and the spouse
retired prior to the beneficiary's Medicare A entitlement date, use the patient's Medicare
entitlement date.
3. If the beneficiary worked beyond their Medicare A entitlement date and it has been at
least five years since they retired, enter the date of service five years ago.
4. If the retirement date occurred less than five years ago, the hospital must obtain the
retirement dates from other resources.
✔✔What constitutes a recurring visit? How often do you need to verify MSP's? - ✔✔Per
CMS regulations, for recurring visits (where one account is created and the patient has
several recurring visits for the same service, such as physical therapy, all charges for
each visit are entered into the one account), you are required to verify the patient's MSP
information every 90 days to ensure the information is current and updated as needed.
✔✔Pt is 65+ and covered by a GHP through current employment or spouce's current
employment.
The individual is entitled to medicare.
The employer has less than 20 employees.
What is the order of coverage? - ✔✔1st Medicare
2nd GHP
,✔✔Pt is 65+ and covered by a GHP through current employment or spouce's current
employment.
The individual is entitled to medicare.
The employer has 20 or more employees, or the employer is part of a multi-employer
group with at least one employer employing 20 or more individuals.
What is the order of coverage? - ✔✔1st GHP
2nd Medicare
✔✔Pt is 65+ and covered by a retirement GHP, not working.
The individual is entitled to medicare.
What is the order of coverage? - ✔✔1st Medicare
2nd Retiree Coverage
✔✔Pt under age 65 and didabled, covered by GHP through current employment or
through family members current employment.
The individual is entitled to medicare.
The employer has less than 100 employees.
What is the order of coverage? - ✔✔1st Medicare
2nd GHP
✔✔Pt is under 65 and disabled. Covered by a GHP through current employment or
family current employment.
The individual is entitled to medicare.
The employer has 100 or more employees, or is part of a multi-employer group with at
least 1 having over 100 employees.
What is the order of coverage? - ✔✔1st GHP
2nd Medicare
✔✔Pt has ESRD and GHP coverage was the primary plan prior to the individual
becoming eligible and entitled to medicare based on ESRD.
First 30 months of medicare eligibility or entitlement.
What is the order of coverage? - ✔✔1st GHP
, 2nd Medicare
✔✔Pt has ESRD and GHP coverage.
After 30 months of medicare eligibility or entitlement.
What is the order of coverage? - ✔✔1st Medicare
2nd GHP
✔✔Has ESRD and COBRA coverage prior to becoming eligible or entitled to medicare.
First 30 months of medicare eligibility or entitlement.
What is the order of coverage? - ✔✔1st COBRA
2nd Medicare
✔✔COBRA - ✔✔Consolidated Omnibus Budget Reconciliation Act of 1985
✔✔Pt has ESRD and COBRA coverage.
After 30 months of medicare eligibility or entitlement.
What is the order of coverage? - ✔✔1st Medicare
2nd COBRA
✔✔Pt is covered under Workers Comp because of a job-related illness or injury.
The individual is entitled to medicare.
What is the order of coverage? - ✔✔1st WC for health care items or services related to
job-related illness or injury.
2nd Medicare
✔✔According to medicare, how much money was lost in 2015 due to fraud, waste,
abuse and improper payment? - ✔✔$60 billion
✔✔Fraud - ✔✔Fraud is the intentional deception or
misrepresentation.
✔✔Abuse - ✔✔Abuse is when healthcare providers unintentionally bill incorrectly,
causing unnecessary costs.
✔✔Examples of fraud and abuse: - ✔✔-Billing for services not rendered
-Billing for services multiple times
