CHAM Definitions Exam questions and
Answers 100% Verified
Bad Debt - -an accounts receivable that is regarded as uncollectable and is
charged as a credit loss, even thought the patient has the ability to pay
- Appropriate care - -A diagnostic or treatment measure whose expected
health benefit exceeds its expected health risk by a wide enough margin to
justify the measure
- Access - -the patients ability to obtain medical care
- Components that determine access - -• Availability of medical services
• Acceptability to the patient
• Location of the facility
• Transportation
• Hours
• Cost of care
- Attending Physician - -the physician who writes outpatient orders for tests
or supervises the patients care during an inpatient stay
- Authorization - -Approval obtained from an insurance carrier for a service
that represents an agreement for payment
- Admission Date - -the first date the patient entered the hospital for a
specific visit
- Adjustor - -Insurance company representative
- Acute inpatient care - -a level of care delivered to patients experiencing
acute illness or trauma. Acute care generally short term.
- Admission authorization - -the process of third party payer notification of
an urgent/emergent inpatient admission within a specified time determined
by payers
- Administrative costs - -costs associated with creating and submitting a bill
for services, which could include registration, utilization review, coding,
billing and collection expenses
- Add-ons - -patients who are scheduled for services less than 24 hours in
advance of the actual service time
, - Ambulatory surgical center - -a freestanding facility, other than a
physician's office where surgical, diagnostic and therapeutic services are
provided on an outpatient ambulatory basis
- Appeal - -a special kind of complaint made when a beneficiary or provider
disagrees with decision about health care services
- Advance beneficiary notice - -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 might not pay for them
- Ancillary services - -a unit of the hospital, other than a nursing unit, which
provides medical services such as diagnostic testing therapeutic procedures
or dispenses medical products
- Assignment of benefits - -a written authorization from a policyholder for
their insurance company to pay benefits directly to the care provider
- Admitting physician - -the physician that writes the order for the patient to
be admitted to the hospital
- Accepting assignment - -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 providers normal fee
- Ambulatory care patient - -patient receiving care in an outpatient setting
that involves a less specialized range of care
- Advance directive - -a written instruction relating to the provision of
healthcare when a patient is incapacitated
- Behavioral health - -assessment and treatment of mental and or
psychiatric substance abuse disorders
- Balance billing - -the practice of billing a patient for the fee amount
remaining after insurer payment and co-payment has been made
- Beneficiary - -person designated to receive the proceeds of an insurance
policy; the insured under a health insurance policy
- Benefit verification - -the process of confirming benefits for services; the
process of verification of demographic, financial and insurance information
- Benefit period - -the number of days that Medicare covers care in hospitals
or skilled nursing facilities; begins on the first day of services and ends 60
days after discharge
Answers 100% Verified
Bad Debt - -an accounts receivable that is regarded as uncollectable and is
charged as a credit loss, even thought the patient has the ability to pay
- Appropriate care - -A diagnostic or treatment measure whose expected
health benefit exceeds its expected health risk by a wide enough margin to
justify the measure
- Access - -the patients ability to obtain medical care
- Components that determine access - -• Availability of medical services
• Acceptability to the patient
• Location of the facility
• Transportation
• Hours
• Cost of care
- Attending Physician - -the physician who writes outpatient orders for tests
or supervises the patients care during an inpatient stay
- Authorization - -Approval obtained from an insurance carrier for a service
that represents an agreement for payment
- Admission Date - -the first date the patient entered the hospital for a
specific visit
- Adjustor - -Insurance company representative
- Acute inpatient care - -a level of care delivered to patients experiencing
acute illness or trauma. Acute care generally short term.
- Admission authorization - -the process of third party payer notification of
an urgent/emergent inpatient admission within a specified time determined
by payers
- Administrative costs - -costs associated with creating and submitting a bill
for services, which could include registration, utilization review, coding,
billing and collection expenses
- Add-ons - -patients who are scheduled for services less than 24 hours in
advance of the actual service time
, - Ambulatory surgical center - -a freestanding facility, other than a
physician's office where surgical, diagnostic and therapeutic services are
provided on an outpatient ambulatory basis
- Appeal - -a special kind of complaint made when a beneficiary or provider
disagrees with decision about health care services
- Advance beneficiary notice - -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 might not pay for them
- Ancillary services - -a unit of the hospital, other than a nursing unit, which
provides medical services such as diagnostic testing therapeutic procedures
or dispenses medical products
- Assignment of benefits - -a written authorization from a policyholder for
their insurance company to pay benefits directly to the care provider
- Admitting physician - -the physician that writes the order for the patient to
be admitted to the hospital
- Accepting assignment - -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 providers normal fee
- Ambulatory care patient - -patient receiving care in an outpatient setting
that involves a less specialized range of care
- Advance directive - -a written instruction relating to the provision of
healthcare when a patient is incapacitated
- Behavioral health - -assessment and treatment of mental and or
psychiatric substance abuse disorders
- Balance billing - -the practice of billing a patient for the fee amount
remaining after insurer payment and co-payment has been made
- Beneficiary - -person designated to receive the proceeds of an insurance
policy; the insured under a health insurance policy
- Benefit verification - -the process of confirming benefits for services; the
process of verification of demographic, financial and insurance information
- Benefit period - -the number of days that Medicare covers care in hospitals
or skilled nursing facilities; begins on the first day of services and ends 60
days after discharge
