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CHAM 2025/2026 – 200+ Definitions with Correct Answers | Insurance Terms, Patient Access, CMS, HIPAA, Compliance, Billing & Healthcare Finance

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This CHAM (Certified Healthcare Access Manager) 2025/2026 reference guide presents over 200 up-to-date definitions and accurate answers, covering key terminology and foundational knowledge areas essential for success on the NAHAM CHAM exam. Designed as both a glossary and practice tool, this document helps candidates build mastery in healthcare operations, financial processes, compliance, and patient access systems. Core areas include: Insurance & Payer Terms: Capitation, Fee-for-Service, Deductibles, Co-pays, Co-insurance, Primary/Secondary Payer rules, Medicare Part A/B, Medigap, Lifetime Reserve Days Patient Access Functions: Admission authorization, access barriers, pre-registration, financial class codes, encounter types, authorization requirements Billing & Coding: CMS-1500, UB-04, HCPCS, CPT, ICD, claims processing, fiscal intermediaries, charge description master (CDM) Regulatory & Legal Compliance: HIPAA, COBRA, OBRA, Advance Directives, Consent to Treat, Balance Billing, OIG, CMS oversight Healthcare Settings & Providers: Acute care, ambulatory surgical centers, birthing centers, hospice, CAHs, custodial care, conservatorship Financial Administration: Bad debt, charity care, billing cycles, collection agencies, reimbursement methods, default values, administrative costs Patient Rights & Support Systems: Durable Power of Attorney, patient rights, behavioral health support, family liaison, case management This document is a must-have for: CHAM candidates preparing for the 2025/2026 NAHAM certification exam Healthcare administration and HIM students at associate, bachelor’s, or master’s level Patient access managers, coordinators, and hospital registration staff Revenue cycle and compliance teams in hospitals, clinics, and outpatient centers Trainers, supervisors, and educators in patient access operations and policy implementation With real-world terminology explained clearly and aligned to test-ready definitions, this document ensures thorough preparation and on-the-job applicability for anyone involved in healthcare access and administrative services. Keywords: CHAM exam, patient access definitions, NAHAM glossary, healthcare compliance, HIPAA, insurance terms, Medicare Part A B, payer policy, CMS 1500, UB-04, billing process, revenue cycle, bad debt, charity care, pre-registration, deductible, copay, case management, conservatorship, OIG, CMS, CPT, ICD codes

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CHAM Certified Healthcare Access Manager
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CHAM Certified Healthcare Access Manager









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Institution
CHAM Certified Healthcare Access Manager
Course
CHAM Certified Healthcare Access Manager

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Uploaded on
August 3, 2025
Number of pages
14
Written in
2025/2026
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Exam (elaborations)
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Questions & answers

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CHAM Definitions 2025/2026 Exam
Questions and Correct Answers | New
Update



Bad Debt - 🧠 ANSWER ✔✔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 - 🧠 ANSWER ✔✔A diagnostic or treatment measure whose

expected health benefit exceeds its expected health risk by a wide enough margin

to justify the measure


Access - 🧠 ANSWER ✔✔the patients ability to obtain medical care


Components that determine access - 🧠 ANSWER ✔✔• Availability of medical

services

• Acceptability to the patient

, • Location of the facility

• Transportation

• Hours

• Cost of care


Attending Physician - 🧠 ANSWER ✔✔the physician who writes outpatient orders

for tests or supervises the patients care during an inpatient stay


Authorization - 🧠 ANSWER ✔✔Approval obtained from an insurance carrier for a

service that represents an agreement for payment


Admission Date - 🧠 ANSWER ✔✔the first date the patient entered the hospital for

a specific visit


Adjustor - 🧠 ANSWER ✔✔Insurance company representative


Acute inpatient care - 🧠 ANSWER ✔✔a level of care delivered to patients

experiencing acute illness or trauma. Acute care generally short term.


Admission authorization - 🧠 ANSWER ✔✔the process of third party payer

notification of an urgent/emergent inpatient admission within a specified time

determined by payers

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