CHAA Certification with Verified
solutions
Census Verification ✔️✔️The process of accurately accounting for all Admission-
Discharge-Transfer (ADT) activity within or across entities.
Centers for DiseaseControl and Prevention (CDC) ✔️✔️The Centers for Disease Control and
Prevention (CDC) is one of the major operating components of the Department of Health and
Human Services. The CDC works with partners throughout the nation and the world to: monitor
health, detect and investigate health problems, conduct research to enhance prevention, develop
and advocate sound public health policies, implement prevention strategies, promote healthy
behaviors, foster safe and healthful environments, and provide leadership and training. The
CDC's mission is to promote health and quality of life by preventing and controlling disease,
injury, and disability
Centers for Medicare and Medicaid Services (CMS) ✔️✔️Centers for Medicare and Medicaid
Services (CMS) is a federal agency within the U.S. Department of Health and Human Services.
CMS is responsible for the administration of the Medicare and other health-related programs as
well as Medicaid and the State Children's Health Insurance Program (SCHIP), which serves
many of the uninsured children in the United States.
Charge Description Master (CDM) ✔️✔️Charge Description Master is a master file in the
computer
,system listing the services provided at the hospital that have an assigned charge. A unique
number is assigned to each charge. Also included is a description of the service, a code for the
department rendering care, applicable HCPCS/ Healthcare Common Procedure Coding
System/Current Procedural Terminology (CPT) code, and other information.
Charity Care ✔️✔️Financial Assistance program available to qualifying patients based on
financial need.
Civilian Health and Medical Program of
the Uniformed Services (CHAMPUS) ✔️✔️Civilian Health and Medical Program of the
Uniformed Services has been replaced by TRICARE.
Claim ✔️✔️An itemized statement of health care services and their costs provided by a
hospital, physician's office or other provider facility. Claims are submitted to the insurer or
managed careplan by either the plan member or the provider for payment of the costs incurred.
Claimant ✔️✔️The person or enity submitting a claim
Claims Administration ✔️✔️Employees in the claims administration department who
consider all the information pertinent to a claim and make
decisions about the Managed Care Organization's (MCO)
payment of the claim. Also known as claims analysts
, clinic ✔️✔️A medical or surgical specialty unit of a hospital or hospitals' free standing facility
where a patient is seen on an ambulatory basis but remains the hospital's responsibility for
ongoing care and disposition.
Clinical Data Repository (CDR) ✔️✔️The process of receiving, reviewing, adjudicating and
processing claims
Clinical Integration ✔️✔️A type of operational integration that enables patients to receive a
variety of health services from the same organization or entity, which streamlines administrative
processes and increases the potential for the delivery of high-quality health care.
Closed Access ✔️✔️A provision which specifies that plan members must obtain medical
services only from network providers through a primary care physician to receive benefits.
CMS 1450 (UB-04) ✔️✔️A revised version of the UB-92, a federal directive requiring a
hospital to follow specific billing procedures itemizing all services included and billed for on
each invoice. Uniform bill mandated by the Centers for Medicare and Medicaid Services (CMS)
for use by hospitals, skilled nursing facilities, home health agencies, community mental health
facilities, etc
Co-insurance ✔️✔️Co-insurance is another amount the third party payor can identify as the
Patient/Guarantor's responsibility. Coinsurance is usually a percentage of the total billed amount.
solutions
Census Verification ✔️✔️The process of accurately accounting for all Admission-
Discharge-Transfer (ADT) activity within or across entities.
Centers for DiseaseControl and Prevention (CDC) ✔️✔️The Centers for Disease Control and
Prevention (CDC) is one of the major operating components of the Department of Health and
Human Services. The CDC works with partners throughout the nation and the world to: monitor
health, detect and investigate health problems, conduct research to enhance prevention, develop
and advocate sound public health policies, implement prevention strategies, promote healthy
behaviors, foster safe and healthful environments, and provide leadership and training. The
CDC's mission is to promote health and quality of life by preventing and controlling disease,
injury, and disability
Centers for Medicare and Medicaid Services (CMS) ✔️✔️Centers for Medicare and Medicaid
Services (CMS) is a federal agency within the U.S. Department of Health and Human Services.
CMS is responsible for the administration of the Medicare and other health-related programs as
well as Medicaid and the State Children's Health Insurance Program (SCHIP), which serves
many of the uninsured children in the United States.
Charge Description Master (CDM) ✔️✔️Charge Description Master is a master file in the
computer
,system listing the services provided at the hospital that have an assigned charge. A unique
number is assigned to each charge. Also included is a description of the service, a code for the
department rendering care, applicable HCPCS/ Healthcare Common Procedure Coding
System/Current Procedural Terminology (CPT) code, and other information.
Charity Care ✔️✔️Financial Assistance program available to qualifying patients based on
financial need.
Civilian Health and Medical Program of
the Uniformed Services (CHAMPUS) ✔️✔️Civilian Health and Medical Program of the
Uniformed Services has been replaced by TRICARE.
Claim ✔️✔️An itemized statement of health care services and their costs provided by a
hospital, physician's office or other provider facility. Claims are submitted to the insurer or
managed careplan by either the plan member or the provider for payment of the costs incurred.
Claimant ✔️✔️The person or enity submitting a claim
Claims Administration ✔️✔️Employees in the claims administration department who
consider all the information pertinent to a claim and make
decisions about the Managed Care Organization's (MCO)
payment of the claim. Also known as claims analysts
, clinic ✔️✔️A medical or surgical specialty unit of a hospital or hospitals' free standing facility
where a patient is seen on an ambulatory basis but remains the hospital's responsibility for
ongoing care and disposition.
Clinical Data Repository (CDR) ✔️✔️The process of receiving, reviewing, adjudicating and
processing claims
Clinical Integration ✔️✔️A type of operational integration that enables patients to receive a
variety of health services from the same organization or entity, which streamlines administrative
processes and increases the potential for the delivery of high-quality health care.
Closed Access ✔️✔️A provision which specifies that plan members must obtain medical
services only from network providers through a primary care physician to receive benefits.
CMS 1450 (UB-04) ✔️✔️A revised version of the UB-92, a federal directive requiring a
hospital to follow specific billing procedures itemizing all services included and billed for on
each invoice. Uniform bill mandated by the Centers for Medicare and Medicaid Services (CMS)
for use by hospitals, skilled nursing facilities, home health agencies, community mental health
facilities, etc
Co-insurance ✔️✔️Co-insurance is another amount the third party payor can identify as the
Patient/Guarantor's responsibility. Coinsurance is usually a percentage of the total billed amount.
