CHAM EXAM EXPECTED QUESTIONS WITH VERIFIED
ANSWERS
Question 1.
When a provider agrees to accept the allowable charges as the full fee and cannot charge the patient
the difference between the insurance payment and the provider's normal fee.
ANSWER
Accepting Assignment
Question 2.
The patient's ability to obtain medical care. The ease of access is determined by such components as
the availability of medical services and their acceptability to the patient, the location of health-care
facilities, transportation, hours of operation and cost of care.
ANSWER
Access
Question 3.
A number assigned to each account. This number is used to identify the account and all charges and
payments received.
ANSWER
Account Number
Question 4.
Medical attention given to patients with conditions of sudden onset that demand urgent attention or
care of limited duration when the patient's health and wellness would deteriorate without treatment.
The care is generally short-term rather than long-term or chronic care.
ANSWER
Acute Care
,Question 5.
A level of health-care delivered to patients experiencing acute illness or trauma. Acute care is generally
short-term (< 30 days).
ANSWER
Acute Impatient Care
Question 6.
Patients who are scheduled for services less than 24 hours in advance of the actual service time.
ANSWER
Add-Ons
Question 7.
Insurance company representative.
ANSWER
Adjustor
Question 8.
Costs associated with creating and submitting a bill for services, which could include: registration,
utilization review, coding, billing and collection expenses
ANSWER
Administrative Costs
Question 9.
The process of third-party payer notification of urgent/emergent inpatient admission within specified
time as determined by payers (usually 24-48 hours or next business day).
ANSWER
Admission Authorization
Question 10.
The first date the patient entered the hospital for a specific visit
ANSWER
Admission Date
,Question 11.
Word, phrase or International Classification of Disease (ICD9) code used by the admitting physician to
identify a condition or disease from which a patient suffers and for which the patient needs or seeks
medical care.
ANSWER
Admitting Diagnosis
Question 12.
The physician who writes the order for the patient to be admitted to the hospital. This physician must
have admitting privileges at the facility providing the healthcare services.
ANSWER
Admitting Physician
Question 13.
A notice that a care provider should give a Medicare beneficiary to sign if the services being provided
may not be considered medically necessary and Medicare may not pay for them. The advance
beneficiary notice (ABN) allows the beneficiary to make an informed decision prior to services
regarding whether or not they wish to receive services. ABNs are not routinely given to emergency
department patients.
ANSWER
Advance Beneficiary Notice (ABN)
Question 14.
is a written instruction relating to the provision of healthcare when a patient is incapacitated. It could
include appointing someone to make medical decisions, a statement expressing the patient's wishes
about anatomical gifts (i.e. organ donation) and general statements about whether or not life-
sustaining treatments should be withheld or withdrawn.
ANSWER
Advance Directive
, Question 15.
Among applicants for a given group or individual program, the tendency for those with an impaired
health status, or who are prone to higher than average utilization of benefits to be enrolled in
disproportionate numbers and lower deductible plans
ANSWER
Adverse Selection
Question 16.
a name by which the patient is also "known as," or formerly known as
ANSWER
Alias
Question 17.
A prospective hospital claims reimbursement system currently utilized by the federal government
Medicaid program and the states of New York and New Jersey. They were designed to describe the
complete cross section of patients seen in acute care hospitals. Approximately 639 ___ are defined
according to the principal diagnosis, secondary diagnoses, procedures, age, birth weight, sex and
discharge status. Each category has an established fixed reimbursement rate based on average cost of
treatment within a geographic area. Theywere developed to quantify the difference in demographic
groups and clinical risk factors for patients treated in hospitals. This proprietary grouping system's (i.e.
3M) purpose is to obtain fair and accurate statistical comparisons between disparate populations and
groups. Unlike the Diagnosis Related Group (DRG) reimbursement system, which is intended to
capture resource utilization intensity, the system captures and relates the Severity of Illness and Risk of
Mortality factors present as a result of a patient's disease and disorders and the interaction of those
disorders. A form is signed by the Patient giving the healthcare provider authority to bill his/her
insurance plan and receive payment. The form is generally presented and signed at the time of
registration.
ANSWER
All Patient Diagnosis Related Groups Assignment of Benefits (APDRG)
Question 18.
Letters, numbers, punctuation marks and mathematical symbols, as opposed to "numeric," which is
numbers only. Term typically related to the kind of data accepted in a computer field or in coding.
ANSWER
Alphanumeric
ANSWERS
Question 1.
When a provider agrees to accept the allowable charges as the full fee and cannot charge the patient
the difference between the insurance payment and the provider's normal fee.
ANSWER
Accepting Assignment
Question 2.
The patient's ability to obtain medical care. The ease of access is determined by such components as
the availability of medical services and their acceptability to the patient, the location of health-care
facilities, transportation, hours of operation and cost of care.
ANSWER
Access
Question 3.
A number assigned to each account. This number is used to identify the account and all charges and
payments received.
ANSWER
Account Number
Question 4.
Medical attention given to patients with conditions of sudden onset that demand urgent attention or
care of limited duration when the patient's health and wellness would deteriorate without treatment.
The care is generally short-term rather than long-term or chronic care.
ANSWER
Acute Care
,Question 5.
A level of health-care delivered to patients experiencing acute illness or trauma. Acute care is generally
short-term (< 30 days).
ANSWER
Acute Impatient Care
Question 6.
Patients who are scheduled for services less than 24 hours in advance of the actual service time.
ANSWER
Add-Ons
Question 7.
Insurance company representative.
ANSWER
Adjustor
Question 8.
Costs associated with creating and submitting a bill for services, which could include: registration,
utilization review, coding, billing and collection expenses
ANSWER
Administrative Costs
Question 9.
The process of third-party payer notification of urgent/emergent inpatient admission within specified
time as determined by payers (usually 24-48 hours or next business day).
ANSWER
Admission Authorization
Question 10.
The first date the patient entered the hospital for a specific visit
ANSWER
Admission Date
,Question 11.
Word, phrase or International Classification of Disease (ICD9) code used by the admitting physician to
identify a condition or disease from which a patient suffers and for which the patient needs or seeks
medical care.
ANSWER
Admitting Diagnosis
Question 12.
The physician who writes the order for the patient to be admitted to the hospital. This physician must
have admitting privileges at the facility providing the healthcare services.
ANSWER
Admitting Physician
Question 13.
A notice that a care provider should give a Medicare beneficiary to sign if the services being provided
may not be considered medically necessary and Medicare may not pay for them. The advance
beneficiary notice (ABN) allows the beneficiary to make an informed decision prior to services
regarding whether or not they wish to receive services. ABNs are not routinely given to emergency
department patients.
ANSWER
Advance Beneficiary Notice (ABN)
Question 14.
is a written instruction relating to the provision of healthcare when a patient is incapacitated. It could
include appointing someone to make medical decisions, a statement expressing the patient's wishes
about anatomical gifts (i.e. organ donation) and general statements about whether or not life-
sustaining treatments should be withheld or withdrawn.
ANSWER
Advance Directive
, Question 15.
Among applicants for a given group or individual program, the tendency for those with an impaired
health status, or who are prone to higher than average utilization of benefits to be enrolled in
disproportionate numbers and lower deductible plans
ANSWER
Adverse Selection
Question 16.
a name by which the patient is also "known as," or formerly known as
ANSWER
Alias
Question 17.
A prospective hospital claims reimbursement system currently utilized by the federal government
Medicaid program and the states of New York and New Jersey. They were designed to describe the
complete cross section of patients seen in acute care hospitals. Approximately 639 ___ are defined
according to the principal diagnosis, secondary diagnoses, procedures, age, birth weight, sex and
discharge status. Each category has an established fixed reimbursement rate based on average cost of
treatment within a geographic area. Theywere developed to quantify the difference in demographic
groups and clinical risk factors for patients treated in hospitals. This proprietary grouping system's (i.e.
3M) purpose is to obtain fair and accurate statistical comparisons between disparate populations and
groups. Unlike the Diagnosis Related Group (DRG) reimbursement system, which is intended to
capture resource utilization intensity, the system captures and relates the Severity of Illness and Risk of
Mortality factors present as a result of a patient's disease and disorders and the interaction of those
disorders. A form is signed by the Patient giving the healthcare provider authority to bill his/her
insurance plan and receive payment. The form is generally presented and signed at the time of
registration.
ANSWER
All Patient Diagnosis Related Groups Assignment of Benefits (APDRG)
Question 18.
Letters, numbers, punctuation marks and mathematical symbols, as opposed to "numeric," which is
numbers only. Term typically related to the kind of data accepted in a computer field or in coding.
ANSWER
Alphanumeric
