CHAM Chamberlain 2025 Update QUESTIONS
WITH CORRECT ANSWERS
1. Accepting AssignmentANSWERS When a provider agrees to accept the allowable charges as
the full fee and cannot charge the patient the ditterence between the insurance payment and the
provider's normal fee.
2. AccessANSWERS 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.
3. Account NumberANSWERS A number assigned to each account. This number is used to identify
the account and all
Charges and payments received.
4. Acute CareANSWERS 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.
5. Acute Impatient CareANSWERS A level of healthcare delivered to patients experiencing acute
illness or trauma.
Generally short-term (<30 days).
6. Add OnsANSWERS Patients who are scheduled for services less than 24 hours in advance of the
actual service time.
7. AdjustorANSWERS Insurance company representative.
8. Administrative CostsANSWERS Costs associated with creating and submitting a bill for services,
which could includeANSWERS registration, utilization review, coding, billing, and collection expenses.
9. Admission AuthorizationANSWERS 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).
,10. Admission DateANSWERS The first date the patient entered the hospital for a specific visit.
11. Admitting DiagnosisANSWERS Word, phrase, or International Classification of Disease
(ICD10) code used by the admitting physician to identify a condition or disease from which a patient
sutters and for which the patient needs or seeks medical care.
12. Admitting PhysicianANSWERS The physician who writes the order for the patient to
admitted to the hospital.
The physician must have admitting privileges at the facility providing the healthcare services.
13. Advance Beneficiary NoticeANSWERS 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.
14. Advance DirectiveANSWERS A written instruction relating to the provision of healthcare when
patient is incapac-
Itated. 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.
,15. Adverse SelectionANSWERS 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.
16. AliasANSWERS A name by which the patient is also "known as", or formerly known as.
17. All Patient Diagnosis Related Groups Assignment of Benefits
(APDRG)ANSWERS 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 ditterence 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.
18. AlphanumericANSWERS 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.
19. Ambulatory Care PatientANSWERS 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.
20. Ambulatory Payment Classification (APC)ANSWERS A system of averaging a
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.
21. Ambulatory Surgical CenterANSWERS A freestanding facility, other than a physicia
oflce, where surgical,
Diagnostic, and therapeutic services are provided on an outpatient ambulatory basis.
22. Ancillary ServicesANSWERS A unit of the hospital, other than a nursing unit, that provides
medical services such as diagnostic testing and therapeutic procedures, or dispenses medical products,
such as medications or medical/surgical supplies. ExamplesANSWERS Laboratory, Medical Imaging,
Physical Therapy and Pharmacy. Ancillary is used to describe diag-
WITH CORRECT ANSWERS
1. Accepting AssignmentANSWERS When a provider agrees to accept the allowable charges as
the full fee and cannot charge the patient the ditterence between the insurance payment and the
provider's normal fee.
2. AccessANSWERS 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.
3. Account NumberANSWERS A number assigned to each account. This number is used to identify
the account and all
Charges and payments received.
4. Acute CareANSWERS 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.
5. Acute Impatient CareANSWERS A level of healthcare delivered to patients experiencing acute
illness or trauma.
Generally short-term (<30 days).
6. Add OnsANSWERS Patients who are scheduled for services less than 24 hours in advance of the
actual service time.
7. AdjustorANSWERS Insurance company representative.
8. Administrative CostsANSWERS Costs associated with creating and submitting a bill for services,
which could includeANSWERS registration, utilization review, coding, billing, and collection expenses.
9. Admission AuthorizationANSWERS 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).
,10. Admission DateANSWERS The first date the patient entered the hospital for a specific visit.
11. Admitting DiagnosisANSWERS Word, phrase, or International Classification of Disease
(ICD10) code used by the admitting physician to identify a condition or disease from which a patient
sutters and for which the patient needs or seeks medical care.
12. Admitting PhysicianANSWERS The physician who writes the order for the patient to
admitted to the hospital.
The physician must have admitting privileges at the facility providing the healthcare services.
13. Advance Beneficiary NoticeANSWERS 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.
14. Advance DirectiveANSWERS A written instruction relating to the provision of healthcare when
patient is incapac-
Itated. 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.
,15. Adverse SelectionANSWERS 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.
16. AliasANSWERS A name by which the patient is also "known as", or formerly known as.
17. All Patient Diagnosis Related Groups Assignment of Benefits
(APDRG)ANSWERS 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 ditterence 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.
18. AlphanumericANSWERS 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.
19. Ambulatory Care PatientANSWERS 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.
20. Ambulatory Payment Classification (APC)ANSWERS A system of averaging a
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.
21. Ambulatory Surgical CenterANSWERS A freestanding facility, other than a physicia
oflce, where surgical,
Diagnostic, and therapeutic services are provided on an outpatient ambulatory basis.
22. Ancillary ServicesANSWERS A unit of the hospital, other than a nursing unit, that provides
medical services such as diagnostic testing and therapeutic procedures, or dispenses medical products,
such as medications or medical/surgical supplies. ExamplesANSWERS Laboratory, Medical Imaging,
Physical Therapy and Pharmacy. Ancillary is used to describe diag-
