CHAA EXAM TEST BANK WITH OVER
300 QUESTIONS AND CORRECT
ANSWERS RATED A+ 20262027
[NEWEST!!!]
Healthcare entities
are required to have policies in place that limit how much protected information is used,
disclosed and requested for certain purposes.
Impact patient care
Errors made in registration can ____________________.
The policyholder
may not be the person whose name appears on the insurance card.
CMS's mission
Includes assuring health security for it's beneficiaries.
Health Insurance Portability and Accountability Act (HIPAA)
Funding to combat fraud and abuse is provided through ______________________.
Result in fines
Failure to comply with completing the MSP Questionnaire can
________________________.
Participants of a Medicare Managed Care Plan
are still Medicare beneficiaries and retain their Medicare rights and protections and
receive all regular Medicare covered services.
Commercial Insurance
Blue Cross, Auto Insurance, Workers's Compensation and HMO are all considered
___________________________.
Tricare For Life
will pay all Medicare co-payments and deductibles and cover most of the costs of
certain care not covered by Medicare.
CMS
Centers for Medicare and Medicaid Services: The federal agency responsible for
maintaining and monitoring the Medicare program, beneficiary services, and Medicaid
and state operations.
JCAHO
Joint Commission on Accreditation of Healthcare Organizations
OCR
Office of Civil Rights
PPS
Prospective Payment System
CDR
Clinical Data Repository; a central database that focuses on clinical information
HIPAA
,Health Insurance Portability and Accountability Act
COB
coordination of benefits
CWF
Common Working File
MBN
Medicare Beneficiary Notice
DHHS
Department of Health and Human Services
CHIP
Children's Health Insurance Program
PRO
Peer Review Organization
HMO
health maintenance organization
CHAMPVA
Civilian Health and Medical Program of the Veterans Administration; The Civilian Health
and Medical Program for the Veterans Administration is an insurance program for the
families of veterans.
NAIC
National Association of Insurance Commissioners
A behavior
An action/reaction, The way we conduct ourselves, a role under specific circumstances.
Steps to communication
Encoding, Transmission, and Decoding
Cognitive Characteristics of Adults
At peak of mental abilities; verbal skills; information recall; reasoning.
Internal and external
Patient access service's customers are_____________________.
External Customers
is Vital to ensure a positive healthcare experience for patients.
Demonstrating compassion
is as significant (important) as competence in assuring that a clean & accurate claim is
generated.
All pers Internal and external
Patient access service's customers are_____________________.
External Customers
is Vital to ensure a positive healthcare experience for patients.
Demonstrating compassion
is as significant (important) as competence in assuring that a clean & accurate claim is
generated.
All personnel providing services to patients and families
are responsible for knowing, promoting, and assisting patients to exercise their rights.
At anytime
,A patient can request a copy of their medical record.
Patients expect
All healthcare workers & volunteers are compassionate and caring, Staff members are
technically competent, Privacy is protected and their individual needs are anticipated &
fulfilled, Staff communicates with them using terms & language they understand, and
healthcare workers are sensitive to the inconvenience & stress that result from health
problems.
10
Maximum number of years that a patient's medical record will be maintained.
Pre-Registration
Point where a patient's request such as needs for a translator, special equipment,
dietary requirements, ect be obtained to enable timely referrals to social services and
initiation of discharge planning.
Joint Commission (JCAHO)
This agency's mission is to improve the quality of healthcare for the public by providing
accreditation and related services that support performance improvement in healthcare
organizations.
3 years
Typical JCAHO accreditation cycle
Administrative systems, Financial management systems, and Patient Care Systems
Data collected in Access is shared with other applications.
Quality improvement is based on
Developing and enforcing standards through surveillance, Measuring and improving
outcomes of care, Educating healthcare providers about quality improvement
opportunities, Educating beneficiaries to make good health care choices.
CMS
Responsible for implementing federal quality assurance standards in laboratories,
nursing homes, hospitals, home health agencies and ambulatory surgical centers.
4
Parts of Medicare
60 days
Many of days after a Medicare patient's discharge from an inpatient hospital or skilled
nursing facility does the benefit period end (providing that the patient has not been
readmitted to a facility during that time).
100 days
Days Medicare will pay for in a participating skilled nursing facility when medically
necessary.
Medicare Part B
Component of Medicare helps pay for ambulance transportation.
Medicaid
is funded and administered through a State-federal partnership to provide health care
coverage for certain low income people.
Medicare Part B
Patient must have to be eligible for Tricare For Life.
Insurance Eligibility, Authorization/Pre certification requirements, and deductible and
Co-pay amounts
, The verification of benefits process determines _________________________.
NAIC
In an effort to standardize the Coordination of Benefits rules.
HMO's
Insurance plans that strive to control health care cost by requiring members to receive
services at designated facilities.
Body Language & Visual Behavoir
Non verbal communication clues.
HIPAA
Patient privacy protections are part of this act.
Staff Empathy
According to a Press-Ganey study, ____________________ has a major impact on a
patient's impression of a hospital.
Documented
If it's not _________________________ , it didn't happen
Clinical Prerequisites
Part of this is reviewing service and procedure information with the patient.
Financial Pre - Determination
The method through which the provider identifies actual payment sources and assists
the patient in determining expected reimbursement, their out of pocket expenses and
alternative funding sources.
Point of Service Collection
Collecting the patient's portion of the bill at the time service is rendered.
EMTALA
Federal law enacted in 1986 by CMS to protect patients against discrimination based on
his or her economic status and mandates patients receive a screening exam and
stabilizing treatment when seeking emergency medical care of when in active labor.
Secretary of the DHHS
Validates Joint Commission findings.
Office of Civil Rights (OCR)
responsible for the enforcement of HIPAA regulations.
MPI
Will store at least all medical record numbers associated with that entity's patients.
Policyholder/ Subscriber
Person who contracts with the insurance company for health care coverage.
CMS
Created on March 9, 1977 to consolidate into one agency the responsibility for
administering Medicare and Medicaid.
Prospective Payment System (PPS)
Legislated in 1983. Reduced the growth rate of Medicare outlays for hospital inpatient
services.
DRG
System that pays hospitals a fixed amount per patient based on diagnosis.
APG's or APC's
300 QUESTIONS AND CORRECT
ANSWERS RATED A+ 20262027
[NEWEST!!!]
Healthcare entities
are required to have policies in place that limit how much protected information is used,
disclosed and requested for certain purposes.
Impact patient care
Errors made in registration can ____________________.
The policyholder
may not be the person whose name appears on the insurance card.
CMS's mission
Includes assuring health security for it's beneficiaries.
Health Insurance Portability and Accountability Act (HIPAA)
Funding to combat fraud and abuse is provided through ______________________.
Result in fines
Failure to comply with completing the MSP Questionnaire can
________________________.
Participants of a Medicare Managed Care Plan
are still Medicare beneficiaries and retain their Medicare rights and protections and
receive all regular Medicare covered services.
Commercial Insurance
Blue Cross, Auto Insurance, Workers's Compensation and HMO are all considered
___________________________.
Tricare For Life
will pay all Medicare co-payments and deductibles and cover most of the costs of
certain care not covered by Medicare.
CMS
Centers for Medicare and Medicaid Services: The federal agency responsible for
maintaining and monitoring the Medicare program, beneficiary services, and Medicaid
and state operations.
JCAHO
Joint Commission on Accreditation of Healthcare Organizations
OCR
Office of Civil Rights
PPS
Prospective Payment System
CDR
Clinical Data Repository; a central database that focuses on clinical information
HIPAA
,Health Insurance Portability and Accountability Act
COB
coordination of benefits
CWF
Common Working File
MBN
Medicare Beneficiary Notice
DHHS
Department of Health and Human Services
CHIP
Children's Health Insurance Program
PRO
Peer Review Organization
HMO
health maintenance organization
CHAMPVA
Civilian Health and Medical Program of the Veterans Administration; The Civilian Health
and Medical Program for the Veterans Administration is an insurance program for the
families of veterans.
NAIC
National Association of Insurance Commissioners
A behavior
An action/reaction, The way we conduct ourselves, a role under specific circumstances.
Steps to communication
Encoding, Transmission, and Decoding
Cognitive Characteristics of Adults
At peak of mental abilities; verbal skills; information recall; reasoning.
Internal and external
Patient access service's customers are_____________________.
External Customers
is Vital to ensure a positive healthcare experience for patients.
Demonstrating compassion
is as significant (important) as competence in assuring that a clean & accurate claim is
generated.
All pers Internal and external
Patient access service's customers are_____________________.
External Customers
is Vital to ensure a positive healthcare experience for patients.
Demonstrating compassion
is as significant (important) as competence in assuring that a clean & accurate claim is
generated.
All personnel providing services to patients and families
are responsible for knowing, promoting, and assisting patients to exercise their rights.
At anytime
,A patient can request a copy of their medical record.
Patients expect
All healthcare workers & volunteers are compassionate and caring, Staff members are
technically competent, Privacy is protected and their individual needs are anticipated &
fulfilled, Staff communicates with them using terms & language they understand, and
healthcare workers are sensitive to the inconvenience & stress that result from health
problems.
10
Maximum number of years that a patient's medical record will be maintained.
Pre-Registration
Point where a patient's request such as needs for a translator, special equipment,
dietary requirements, ect be obtained to enable timely referrals to social services and
initiation of discharge planning.
Joint Commission (JCAHO)
This agency's mission is to improve the quality of healthcare for the public by providing
accreditation and related services that support performance improvement in healthcare
organizations.
3 years
Typical JCAHO accreditation cycle
Administrative systems, Financial management systems, and Patient Care Systems
Data collected in Access is shared with other applications.
Quality improvement is based on
Developing and enforcing standards through surveillance, Measuring and improving
outcomes of care, Educating healthcare providers about quality improvement
opportunities, Educating beneficiaries to make good health care choices.
CMS
Responsible for implementing federal quality assurance standards in laboratories,
nursing homes, hospitals, home health agencies and ambulatory surgical centers.
4
Parts of Medicare
60 days
Many of days after a Medicare patient's discharge from an inpatient hospital or skilled
nursing facility does the benefit period end (providing that the patient has not been
readmitted to a facility during that time).
100 days
Days Medicare will pay for in a participating skilled nursing facility when medically
necessary.
Medicare Part B
Component of Medicare helps pay for ambulance transportation.
Medicaid
is funded and administered through a State-federal partnership to provide health care
coverage for certain low income people.
Medicare Part B
Patient must have to be eligible for Tricare For Life.
Insurance Eligibility, Authorization/Pre certification requirements, and deductible and
Co-pay amounts
, The verification of benefits process determines _________________________.
NAIC
In an effort to standardize the Coordination of Benefits rules.
HMO's
Insurance plans that strive to control health care cost by requiring members to receive
services at designated facilities.
Body Language & Visual Behavoir
Non verbal communication clues.
HIPAA
Patient privacy protections are part of this act.
Staff Empathy
According to a Press-Ganey study, ____________________ has a major impact on a
patient's impression of a hospital.
Documented
If it's not _________________________ , it didn't happen
Clinical Prerequisites
Part of this is reviewing service and procedure information with the patient.
Financial Pre - Determination
The method through which the provider identifies actual payment sources and assists
the patient in determining expected reimbursement, their out of pocket expenses and
alternative funding sources.
Point of Service Collection
Collecting the patient's portion of the bill at the time service is rendered.
EMTALA
Federal law enacted in 1986 by CMS to protect patients against discrimination based on
his or her economic status and mandates patients receive a screening exam and
stabilizing treatment when seeking emergency medical care of when in active labor.
Secretary of the DHHS
Validates Joint Commission findings.
Office of Civil Rights (OCR)
responsible for the enforcement of HIPAA regulations.
MPI
Will store at least all medical record numbers associated with that entity's patients.
Policyholder/ Subscriber
Person who contracts with the insurance company for health care coverage.
CMS
Created on March 9, 1977 to consolidate into one agency the responsibility for
administering Medicare and Medicaid.
Prospective Payment System (PPS)
Legislated in 1983. Reduced the growth rate of Medicare outlays for hospital inpatient
services.
DRG
System that pays hospitals a fixed amount per patient based on diagnosis.
APG's or APC's
