CHAA 2024 EXAM 400 QUESTIONS AND VERIFIED ANSWERS
Accreditation - CORRECT ANSWER✅✅✅Defined as "a self-assessment and external peer
assessment process used by healthcare organizations to accurately assess their level of
performance in relation to established standards and to implement ways to continuously
improve."
Acute Care - CORRECT ANSWER✅✅✅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.
Acutre Inpatient Care - CORRECT ANSWER✅✅✅A level of healthcare delivered to
patients experiencing acute illness or trauma, which is generally short-term (<30 days)
Advanced Beneficiary Notice (ABN) - CORRECT ANSWER✅✅✅Written notice issued to
a fee-for-service (Original Medicare) beneficiary before furnishing items or services that are
usually covered by Medicare but are not expected to be paid in a specific instance for certain
reasons, such as lack of medical necessity.
Advance Directive (Living Will) - CORRECT ANSWER✅✅✅Also known as a medical
directive, healthcare directive or a living will, a legal document in which a person has outlined
what they would like to be done if they are no longer able to make decisions for themselves due
to incapacity or illness.
Ambulatory Services/Same-Day Surgery - CORRECT ANSWER✅✅✅Patient receives
surgical treatment and is discharged from the facility within four to six hours of procedure. It can
occur in an outpatient hospital department or in a freestanding ambulatory care facility.
Ancillary Services - CORRECT ANSWER✅✅✅Physician refers patients for scheduled and
non-scheduled services such as radiology, laboratory, and/or other services that are performed in
a hospital or clinic setting. Patients leave the facility once the services are completed.
,Anti-Kickback Statute - CORRECT ANSWER✅✅✅Anti-fraud federal criminal statute that
prohibits offering or exchange of anything of value in exchange for healthcare business referrals,
including cash, rent, expensive hotel stays, etc.
Authorization Requirement - CORRECT ANSWER✅✅✅Requirement by some insurances
needed for certain services while other procedures might not. CPT might also be required.
Batch Processing - CORRECT ANSWER✅✅✅Execution of a series of jobs in a computer
program without manual intervention; it is used to help maximize the use of computer resources
and stabilize response time by performing system-intensive work during hours when users are
less likely to require access. Unlike real-time transactions, jobs executed in this way are not
available for users to view until after the process in run.
Carve Out - CORRECT ANSWER✅✅✅A decision to separately purchase a service, which
is typically a part of an indemnity of an HMO plan. These may also include medical devices that
the plan pays for in addition to the contracted per diem or case rate. Pre-certification/pre-
authorization is often required for these benefits and services.
Case Management - CORRECT ANSWER✅✅✅Coordination of services to help meet a
patient's healthcare needs
Centers for Medicare and Medicaid Services (CMS) - CORRECT ANSWER✅✅✅Federal
agency under the Department of Health and Humans Services (HHS) that administers Medicare
and partners with state governments for administration of Medicaid and other programs,
including the Children's Health Insurance Program (CHIP).
Civilian Health and Medical Program for the Veterans Administration (CHAMPVA) -
CORRECT ANSWER✅✅✅An insurance program for the families of veterans
Charity Care - CORRECT ANSWER✅✅✅Free or discounted medical care provided to
patients who do not have the ability to pay for all or a part of medical costs due to limited income
or financial hardship.
,Co-Insurance - CORRECT ANSWER✅✅✅The percentage amount that is payable, per
policy provisions, toward medical costs after the deductible has been met.
Condition Code 44 - CORRECT ANSWER✅✅✅Sometimes a Medicare patient is admitted
to a hospital as an inpatient but, upon internal review, the hospital determines the services did not
meet inpatient criteria and the admission is changed to observation.
Co-Payment - CORRECT ANSWER✅✅✅A payment that must be made by a covered
person at the time of service. Services that require this, and the predetermined amount payable
for each service, are specified in the policy. Co-payments may be required for physician visits,
prescriptions or hospital services
Electronic Protected Health Information (ePHI) - CORRECT ANSWER✅✅✅Any PHI as
identified under HIPAA that is produced, saved, received or transferred in an electronic format
Deductible - CORRECT ANSWER✅✅✅The amount of eligible expenses a covered person
must pay each year from his/her own pocket before the plan will begin to pay for eligible
benefits.
DNV-GL Accreditation - CORRECT ANSWER✅✅✅DNV Healthcare is an accreditation
organization approved by CMS in 2008 that has accredited approximately 500 hospitals.
Downtime - CORRECT ANSWER✅✅✅Time the computer system is unavailable to users
Electronic Health Record (EHR) - CORRECT ANSWER✅✅✅A real-time, digitized version
of a patient's medical history that allows secure information access to authorized users. Standard
clinical and medical data is gathered by a provider and stored in electronic files. It goes beyond a
single provider and can contain shared information from multiple providers to develop a
comprehensive patient history.
Emergency Medical Treatment and Labor Act (EMTALA) - CORRECT
ANSWER✅✅✅"Anti-Dumping" statute. Federal law protecting patients against
, discrimination regardless of ability to pay; mandates patients receive a medical screening exam
and stabilizing treatment when seeking emergency medical care or when in active labor.
Emergency Services - CORRECT ANSWER✅✅✅Patients examined on an unscheduled
emergent basis for immediate treatment in the emergency facilities of a hospital. Depending on
the outcome of the exam and treatment, the patient may be admitted as an observation patient,
admitted to the facility as an inpatient, or transferred to another facility as deemed necessary by
the physician.
Ethnicity - CORRECT ANSWER✅✅✅A social group that shares a common and distinctive
culture, religion, language or the like
Exclusions - CORRECT ANSWER✅✅✅Certain procedures are excluded from the plan.
Asking the insurance company will let you know what services are not included and covered in
the plan.
Fair Debt Collection Practices Act (FDCPA) - CORRECT ANSWER✅✅✅Federal law
prohibiting debt collectors from using unfair, abusive or deceptive practices while attempting to
collect from a consumer.
False Claims Act - CORRECT ANSWER✅✅✅Federal law targets fraud against the
government. "Whistleblower's"/qui tam provision allows non-government individuals to "blow
the whistle" in good faith on fraud against the government who may receive up to 30 percent of
any recovered damages.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) - CORRECT
ANSWER✅✅✅A standardized survey of hospital patients that will capture patients' unique
perspectives on hospital care for the purpose of providing the public with comparable
information on hospital quality.
Health Exchange (Health Insurance Marketplace, "Exchange") - CORRECT
ANSWER✅✅✅Organizations that facilitate structured and competitive markets for
purchasing health coverage.
Accreditation - CORRECT ANSWER✅✅✅Defined as "a self-assessment and external peer
assessment process used by healthcare organizations to accurately assess their level of
performance in relation to established standards and to implement ways to continuously
improve."
Acute Care - CORRECT ANSWER✅✅✅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.
Acutre Inpatient Care - CORRECT ANSWER✅✅✅A level of healthcare delivered to
patients experiencing acute illness or trauma, which is generally short-term (<30 days)
Advanced Beneficiary Notice (ABN) - CORRECT ANSWER✅✅✅Written notice issued to
a fee-for-service (Original Medicare) beneficiary before furnishing items or services that are
usually covered by Medicare but are not expected to be paid in a specific instance for certain
reasons, such as lack of medical necessity.
Advance Directive (Living Will) - CORRECT ANSWER✅✅✅Also known as a medical
directive, healthcare directive or a living will, a legal document in which a person has outlined
what they would like to be done if they are no longer able to make decisions for themselves due
to incapacity or illness.
Ambulatory Services/Same-Day Surgery - CORRECT ANSWER✅✅✅Patient receives
surgical treatment and is discharged from the facility within four to six hours of procedure. It can
occur in an outpatient hospital department or in a freestanding ambulatory care facility.
Ancillary Services - CORRECT ANSWER✅✅✅Physician refers patients for scheduled and
non-scheduled services such as radiology, laboratory, and/or other services that are performed in
a hospital or clinic setting. Patients leave the facility once the services are completed.
,Anti-Kickback Statute - CORRECT ANSWER✅✅✅Anti-fraud federal criminal statute that
prohibits offering or exchange of anything of value in exchange for healthcare business referrals,
including cash, rent, expensive hotel stays, etc.
Authorization Requirement - CORRECT ANSWER✅✅✅Requirement by some insurances
needed for certain services while other procedures might not. CPT might also be required.
Batch Processing - CORRECT ANSWER✅✅✅Execution of a series of jobs in a computer
program without manual intervention; it is used to help maximize the use of computer resources
and stabilize response time by performing system-intensive work during hours when users are
less likely to require access. Unlike real-time transactions, jobs executed in this way are not
available for users to view until after the process in run.
Carve Out - CORRECT ANSWER✅✅✅A decision to separately purchase a service, which
is typically a part of an indemnity of an HMO plan. These may also include medical devices that
the plan pays for in addition to the contracted per diem or case rate. Pre-certification/pre-
authorization is often required for these benefits and services.
Case Management - CORRECT ANSWER✅✅✅Coordination of services to help meet a
patient's healthcare needs
Centers for Medicare and Medicaid Services (CMS) - CORRECT ANSWER✅✅✅Federal
agency under the Department of Health and Humans Services (HHS) that administers Medicare
and partners with state governments for administration of Medicaid and other programs,
including the Children's Health Insurance Program (CHIP).
Civilian Health and Medical Program for the Veterans Administration (CHAMPVA) -
CORRECT ANSWER✅✅✅An insurance program for the families of veterans
Charity Care - CORRECT ANSWER✅✅✅Free or discounted medical care provided to
patients who do not have the ability to pay for all or a part of medical costs due to limited income
or financial hardship.
,Co-Insurance - CORRECT ANSWER✅✅✅The percentage amount that is payable, per
policy provisions, toward medical costs after the deductible has been met.
Condition Code 44 - CORRECT ANSWER✅✅✅Sometimes a Medicare patient is admitted
to a hospital as an inpatient but, upon internal review, the hospital determines the services did not
meet inpatient criteria and the admission is changed to observation.
Co-Payment - CORRECT ANSWER✅✅✅A payment that must be made by a covered
person at the time of service. Services that require this, and the predetermined amount payable
for each service, are specified in the policy. Co-payments may be required for physician visits,
prescriptions or hospital services
Electronic Protected Health Information (ePHI) - CORRECT ANSWER✅✅✅Any PHI as
identified under HIPAA that is produced, saved, received or transferred in an electronic format
Deductible - CORRECT ANSWER✅✅✅The amount of eligible expenses a covered person
must pay each year from his/her own pocket before the plan will begin to pay for eligible
benefits.
DNV-GL Accreditation - CORRECT ANSWER✅✅✅DNV Healthcare is an accreditation
organization approved by CMS in 2008 that has accredited approximately 500 hospitals.
Downtime - CORRECT ANSWER✅✅✅Time the computer system is unavailable to users
Electronic Health Record (EHR) - CORRECT ANSWER✅✅✅A real-time, digitized version
of a patient's medical history that allows secure information access to authorized users. Standard
clinical and medical data is gathered by a provider and stored in electronic files. It goes beyond a
single provider and can contain shared information from multiple providers to develop a
comprehensive patient history.
Emergency Medical Treatment and Labor Act (EMTALA) - CORRECT
ANSWER✅✅✅"Anti-Dumping" statute. Federal law protecting patients against
, discrimination regardless of ability to pay; mandates patients receive a medical screening exam
and stabilizing treatment when seeking emergency medical care or when in active labor.
Emergency Services - CORRECT ANSWER✅✅✅Patients examined on an unscheduled
emergent basis for immediate treatment in the emergency facilities of a hospital. Depending on
the outcome of the exam and treatment, the patient may be admitted as an observation patient,
admitted to the facility as an inpatient, or transferred to another facility as deemed necessary by
the physician.
Ethnicity - CORRECT ANSWER✅✅✅A social group that shares a common and distinctive
culture, religion, language or the like
Exclusions - CORRECT ANSWER✅✅✅Certain procedures are excluded from the plan.
Asking the insurance company will let you know what services are not included and covered in
the plan.
Fair Debt Collection Practices Act (FDCPA) - CORRECT ANSWER✅✅✅Federal law
prohibiting debt collectors from using unfair, abusive or deceptive practices while attempting to
collect from a consumer.
False Claims Act - CORRECT ANSWER✅✅✅Federal law targets fraud against the
government. "Whistleblower's"/qui tam provision allows non-government individuals to "blow
the whistle" in good faith on fraud against the government who may receive up to 30 percent of
any recovered damages.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) - CORRECT
ANSWER✅✅✅A standardized survey of hospital patients that will capture patients' unique
perspectives on hospital care for the purpose of providing the public with comparable
information on hospital quality.
Health Exchange (Health Insurance Marketplace, "Exchange") - CORRECT
ANSWER✅✅✅Organizations that facilitate structured and competitive markets for
purchasing health coverage.
