Chaa Certification Latest Update Graded A+

CHAA CERTIFICATION LATEST UPDATE GRADED A+ Admitting physician 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 Advanced Beneficiary Notice (ABN) 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 Attending physician the physician who writes outpatient orders for tests, or supervises the patient's care during an inpatient stay Accepting assignment 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 Ambulatory Surgical Center a freestanding facility, other than a physician's office, where surgical, diagnostic, and therapeutic services are provided on an ambulatory basis Ancillary Service services used in the diagnosis and treatment of medical conditions. Some examples are: lab, medical imaging, cardio-vascular services Ambulatory Patient Classification a system similar to DRG to be used for outpatients. Current scheme includes 346 APC's broken into categories of medical, diagnostic, surgical, and radiology and emergency department and partial hospitalization services Assignment of Benefits written authorization from the policy holder for their insurance company to pay benefits directly to the care provider. Normally acquired at the time of admission or registration Authorization approval obtained from an insurance carrier for a service that represents an agreement for payment Benefit Period the way that Medicare measures the use of hospital and skilled nursing facility and ends when the beneficiary has not received hospital or skilled nursing care for 60 days in a row. After the 60 days have elapsed, a new one begins. The beneficiary must pay the inpatient hospital deductible for each of these. There is no limit on the number of these Capitation a fixed rate of payment to cover a specified set of health services. The rate is usually provided on a per member/ per month basis regardless of the services that are actually rendered Clinical Data Repository (CDR) typically an electronic storage and retrieval system for patient specific medical information Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) this has been replaced by TRICARE Children's Health Insurance Program (CHIPs) a program for uninsured children in the US that is administered by HCFA in conjunction with Health Resources and Services Administration Client Server computer architecture where storage data is separated from the programs that use data- the "server" would a central database located on a computer dedicated to that purpose; the "client" would be a program that requests the data as needed Consolidated Omnibus Budget Reconciliation Act (COBRA) the consolidated omnibus budget reconciliation act of 1985 requires employers to permit employees or family members to continue their group health insurance coverage at their own expense, but at group rates, if they lose coverage because of loss employment, divorce, death of the supporting spouse, or other designated events. Former employees may be required to a pay a 2% administrative fee in addition to the full premium; this coverage generally lasts a maximum of 18 months Co-insurance a method of cost sharing in which the subscriber is responsible for a specified percentage of the cost of healthcare under fee-for-service plans. Plans where the insured is responsible for 20% while the insurance will cover 80% are fairly typical. Frequently, there is a maximum amount the insured is required to pay, called a stop loss amount Consulting Physician physician, other than the admitting or attending physician, who has been asked to participate or provide counsel in a particular episode of care Continuum of Care the scope of healthcare services provided to an individual during a single episode of illness or for multiple conditions