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CRCS - 🧠 ANSWER ✔✔Certified Revenue Cycle Specialist
AAHAM - 🧠 ANSWER ✔✔The American Association of Healthcare
Administrative Management
1-Day Rule - 🧠 ANSWER ✔✔a requirement that all diagnostic or outpatient
services
furnished in connection with the principle admitting diagnosis within one
day prior to the hospital admission are bundled with the inpatient services
for Medicare billing.
,3-Day Rule - 🧠 ANSWER ✔✔a requirement that all diagnostic or outpatient
services
furnished in connection with the principle admitting diagnosis within three
days prior to the hospital admission are bundled with the inpatient services
for Medicare billing.
5010A1 - 🧠 ANSWER ✔✔the American National Standards Institute
transaction for a
professional claim (the electronic equivalent of the CMS 15000),
formerly the 837P
837I - 🧠 ANSWER ✔✔the American National Standards Institute
transaction for an
institutional claim; as a result of HIPAA, it is replacing the electronic
UB-04.
837P - 🧠 ANSWER ✔✔a former American National Standards Institute
transaction for a
professional claim (the electronic equivalent of the CMS 15000),
sincereplaced by the 5010A1.
,ABN - 🧠 ANSWER ✔✔the Advance Beneficiary Notice of Noncoverage; a
form given to a Medicare beneficiary before services are furnished when a
service does not meet or is not expected to meet medical necessity.
abuse - 🧠 ANSWER ✔✔the misuse of a person, substance, service, or
financial matter such that harm is caused; some forms of healthcare abuse
include excessive or unwarranted use of technology, pharmaceuticals, and
services; abuse of authority; and abuse of privacy, confidentiality, or duty to
care; it also includes improper billing practices (like billing Medicare instead
of primary insurer), increasing charges to Medicare beneficiaries but not to
other patients, unbundling of services, and unnecessary transfers of
patients.
Accounts Receivable (AR) Days Outstanding - 🧠 ANSWER ✔✔an estimate,
using average current revenues, of the days required to turn over the
accounts receivable under normal operating conditions; in simple terms,
this is an estimate of the time needed to collect the accounts receivable.
ACF - 🧠 ANSWER ✔✔Administration for Children and Families; one of the
DHHS
Operating Divisions.
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, ACL - 🧠 ANSWER ✔✔Administration for Community Living; one of the
DHHS Operating
Divisions.
actual or expressed consent - 🧠 ANSWER ✔✔written or oral agreement by
the patient to
the treatment outlined.
acute inpatient - 🧠 ANSWER ✔✔a level of healthcare delivered to patients
experiencing
acute illness or trauma; it generally occurs in a hospital or emergency room
and is generally short-term care rather than long-term or chronic care.
ADC - 🧠 ANSWER ✔✔average daily census; the average number of
inpatients maintained in the hospital each day for a specific period of time.
ADRR - 🧠 ANSWER ✔✔Average Days of Revenue in Accounts Receivable;
also known as Accounts Receivable (AR) Days Outstanding; an estimate,
using average current revenues, of the days required to turn over the
accounts receivable under normal operating conditions; in simple terms,
this is an estimate of the time needed to collect the accounts receivable.