CHAM Exam Questions & Answers | 100% Verified
solutions |Questions with Correct Answers 2025 latest
update!!
Accepting Assignment - (ANSWER)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 provider's normal fee.
Access - (ANSWER)The patient's ability to obtain medical care. The ease is
determined by such components as the availability of medical services and their
acceptability to the patient, the location of health-care facilities, transportation,
hours of operation and cost of care.
Account Number - (ANSWER)A number assigned to each account. This number is
used to identify the account and all charges and payments received.
Acute Care - (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. This care is
generally short-term rather than long-term or chronic care.
Acute Impatient Care - (ANSWER)A level of healthcare delivered to patients
experiencing acute illness or trauma. Generally short-term (<30 days).
Add Ons - (ANSWER)Patients who are scheduled for services less than 24 hours in
advance of the actual service time.
,Adjustor - (ANSWER)Insurance company representative.
Administrative Costs - (ANSWER)Costs associated with creating and submitting a
bill for services, which could include: registration, utilization review, coding,
billing, and collection expenses.
Admission Authorization - (ANSWER)The process of third-party payer notification
of urgent/emergent inpatient admission within specified time as determined by
payers (usually 24-48 hours or next business day).
Admission Date - (ANSWER)The first date the patient entered the hospital for a
specific visit.
Admitting Diagnosis - (ANSWER)Word, phrase, or International Classification of
Disease (ICD10) code used by the admitting physician to identify a condition or
disease from which a patient suffers and for which the patient needs or seeks
medical care.
Admitting Physician - (ANSWER)The physician who writes the order for the
patient to be admitted to the hospital. The physician must have admitting
privileges at the facility providing the healthcare services.
Advance Beneficiary Notice - (ANSWER)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. Allows the
beneficiary to make an informed decision prior to services regarding whether or
,not they wish to receive services. Are not routinely given to emergency
department patients.
Advance Directive - (ANSWER)A written instruction relating to the provision of
healthcare when a patient is incapacitated. It could include appointing someone
to make medical decisions, a statement expressing the patient's wishes about
anatomical gifts (i.e. organ donation) and general statements about whether or
not life sustaining treatments should be withheld or withdrawn.
Adverse Selection - (ANSWER)Among applicants for a given group or individual
program, the tendency for those with an impaired health status, or who are prone
to higher than average utilization of benefits to be enrolled in disproportionate
number and lower deductibles.
Alias - (ANSWER)A name by which the patient is also "known as", or formerly
known as.
All Patient Diagnosis Related Groups Assignment of Benefits (APDRG) -
(ANSWER)A prospective hospital claims reimbursement system currently utilized
by the federal government Medicaid program and the states of New York and
New Jersey. Designed to describe the complete cross section of patients seen in
acute care hospitals. Approximately 639 are defined according to the principal
diagnosis, secondary diagnoses, procedures, age, birth weight, sex and discharge
status. Each category has an established fixed reimbursement rate based on
average cost of treatment within a geographic area. Were developed to quantify
the difference in demographic groups and clinical risk factors for patients treated
in hospitals. This proprietary grouping system's (i.e. 3M) purpose is to obtain fair
and accurate statistical comparisons between disparate populations and groups.
Unlike the Diagnosis Related Group (DRG) reimbursement system, which is
, intended to capture resource utilization intensity, this system captures and
relates the severity of illness and risk of mortality factors present as a result of a
patient's disease and disorders and the interaction of those disorders. A form is
signed by the patient giving the healthcare provider authority to bill his/her
insurance plan and receive payment. The form is generally presented and signed
at the time of registration.
Alphanumeric - (ANSWER)Letters, numbers, punctuation marks and
mathematical symbols, as opposed to "numeric" which is numbers only. Term
typically related to the kind of data accepted in a computer field or in coding.
Ambulatory Care Patient - (ANSWER)Patient receives medical or surgical care in
an outpatient setting that involves a broader, less specialized range of care.
Ambulatory patients are generally able to walk and are not confined to a bed. In a
hospital setting, ambulatory care generally refers to healthcare services provided
on an outpatient basis.
Ambulatory Payment Classification (APC) - (ANSWER)A system of averaging and
bundling using Current Procedural Terminology (CPT) procedure codes,
Healthcare Common Procedure Coding System (HCPCS) Level II, and revenue
codes submitted for payment. The ______ system utilizes groups of CPT codes
based on clinical and resource similarity and establishes payment rates for each
______ grouping. The 650+ ______ are divided by significant procedures, medical
services, ancillary services and partial hospitalization services. The ______ are
similar clinically, by resources uses and cost.
Ambulatory Surgical Center - (ANSWER)A freestanding facility, other than a
physician's office, where surgical, diagnostic, and therapeutic services are
provided on an outpatient ambulatory basis.
solutions |Questions with Correct Answers 2025 latest
update!!
Accepting Assignment - (ANSWER)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 provider's normal fee.
Access - (ANSWER)The patient's ability to obtain medical care. The ease is
determined by such components as the availability of medical services and their
acceptability to the patient, the location of health-care facilities, transportation,
hours of operation and cost of care.
Account Number - (ANSWER)A number assigned to each account. This number is
used to identify the account and all charges and payments received.
Acute Care - (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. This care is
generally short-term rather than long-term or chronic care.
Acute Impatient Care - (ANSWER)A level of healthcare delivered to patients
experiencing acute illness or trauma. Generally short-term (<30 days).
Add Ons - (ANSWER)Patients who are scheduled for services less than 24 hours in
advance of the actual service time.
,Adjustor - (ANSWER)Insurance company representative.
Administrative Costs - (ANSWER)Costs associated with creating and submitting a
bill for services, which could include: registration, utilization review, coding,
billing, and collection expenses.
Admission Authorization - (ANSWER)The process of third-party payer notification
of urgent/emergent inpatient admission within specified time as determined by
payers (usually 24-48 hours or next business day).
Admission Date - (ANSWER)The first date the patient entered the hospital for a
specific visit.
Admitting Diagnosis - (ANSWER)Word, phrase, or International Classification of
Disease (ICD10) code used by the admitting physician to identify a condition or
disease from which a patient suffers and for which the patient needs or seeks
medical care.
Admitting Physician - (ANSWER)The physician who writes the order for the
patient to be admitted to the hospital. The physician must have admitting
privileges at the facility providing the healthcare services.
Advance Beneficiary Notice - (ANSWER)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. Allows the
beneficiary to make an informed decision prior to services regarding whether or
,not they wish to receive services. Are not routinely given to emergency
department patients.
Advance Directive - (ANSWER)A written instruction relating to the provision of
healthcare when a patient is incapacitated. It could include appointing someone
to make medical decisions, a statement expressing the patient's wishes about
anatomical gifts (i.e. organ donation) and general statements about whether or
not life sustaining treatments should be withheld or withdrawn.
Adverse Selection - (ANSWER)Among applicants for a given group or individual
program, the tendency for those with an impaired health status, or who are prone
to higher than average utilization of benefits to be enrolled in disproportionate
number and lower deductibles.
Alias - (ANSWER)A name by which the patient is also "known as", or formerly
known as.
All Patient Diagnosis Related Groups Assignment of Benefits (APDRG) -
(ANSWER)A prospective hospital claims reimbursement system currently utilized
by the federal government Medicaid program and the states of New York and
New Jersey. Designed to describe the complete cross section of patients seen in
acute care hospitals. Approximately 639 are defined according to the principal
diagnosis, secondary diagnoses, procedures, age, birth weight, sex and discharge
status. Each category has an established fixed reimbursement rate based on
average cost of treatment within a geographic area. Were developed to quantify
the difference in demographic groups and clinical risk factors for patients treated
in hospitals. This proprietary grouping system's (i.e. 3M) purpose is to obtain fair
and accurate statistical comparisons between disparate populations and groups.
Unlike the Diagnosis Related Group (DRG) reimbursement system, which is
, intended to capture resource utilization intensity, this system captures and
relates the severity of illness and risk of mortality factors present as a result of a
patient's disease and disorders and the interaction of those disorders. A form is
signed by the patient giving the healthcare provider authority to bill his/her
insurance plan and receive payment. The form is generally presented and signed
at the time of registration.
Alphanumeric - (ANSWER)Letters, numbers, punctuation marks and
mathematical symbols, as opposed to "numeric" which is numbers only. Term
typically related to the kind of data accepted in a computer field or in coding.
Ambulatory Care Patient - (ANSWER)Patient receives medical or surgical care in
an outpatient setting that involves a broader, less specialized range of care.
Ambulatory patients are generally able to walk and are not confined to a bed. In a
hospital setting, ambulatory care generally refers to healthcare services provided
on an outpatient basis.
Ambulatory Payment Classification (APC) - (ANSWER)A system of averaging and
bundling using Current Procedural Terminology (CPT) procedure codes,
Healthcare Common Procedure Coding System (HCPCS) Level II, and revenue
codes submitted for payment. The ______ system utilizes groups of CPT codes
based on clinical and resource similarity and establishes payment rates for each
______ grouping. The 650+ ______ are divided by significant procedures, medical
services, ancillary services and partial hospitalization services. The ______ are
similar clinically, by resources uses and cost.
Ambulatory Surgical Center - (ANSWER)A freestanding facility, other than a
physician's office, where surgical, diagnostic, and therapeutic services are
provided on an outpatient ambulatory basis.
