CHAM Exam Questions With 100% Correct Answers

CHAM Exam Questions With 100% Correct Answers Accepting Assignment - answerWhen 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 - answerThe 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 - answerA number assigned to each account. This number is used to identify the account and all charges and payments received. Acute Care - answerMedical 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 - answerA level of healthcare delivered to patients experiencing acute illness or trauma. Generally short-term (<30 days). Add Ons - answerPatients who are scheduled for services less than 24 hours in advance of the actual service time. Adjustor - answerInsurance company representative. Administrative Costs - answerCosts associated with creating and submitting a bill for services, which could include: registration, utilization review, coding, billing, and collection expenses. Admission Authorization - answerThe 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 - answerThe first date the patient entered the hospital for a specific visit. Admitting Diagnosis - answerWord, 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 - answerThe 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 - answerA 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 - answerA 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 - answerAmong 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 - answerA name by which the patient is also "known as", or formerly known as. All Patient Diagnosis Related Groups Assignment of Benefits (APDRG) - answerA 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 - answerLetters, 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 - answerPatient 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.