CHAM TERMS AND DEFINITIONS LATEST
UPDATED
Bad Debt - ANSWER an accounts receivable that is deemed uncollectable and
written off as a credit loss, even though the patient is able to pay
Appropriate care - ANSWER a diagnostic or treatment measure whose
expected health benefit exceeds its expected health risk by a wide enough
margin to justify the measure
Access - ANSWER the capability of the patient to obtain medical care
Elements that affect access - ANSWER • Availability of health services
• Acceptability to the patient
• Facility location
• Transportation
• Hours
• Affordability of care
Attending Physician - ANSWER the doctor who orders outpatient procedures
or directs the patient's care during an inpatient stay
Authorization - ANSWER Approval from an insurance company for a service
that is an agreement to pay
Admission Date - ANSWER the date when the patient was first admitted to the
hospital for a specific visit
Adjustor - ANSWER insurance company representative
, Acute inpatient care - ANSWER a level of care given to patients with acute
illness or injury. Acute care is typically short term.
Admission authorization - ANSWER third party payer notification of an
emergent/urgent inpatient admission within a payers predetermined time
Administrative costs - ANSWER costs associated with the production and
forwarding of a bill for services, which can include registration, utilization
review, coding, billing and collection costs
Add-ons - ANSWER patients who are scheduled for services less than 24 hours
before the actual service time
Ambulatory surgical center - ANSWER a freestanding institution, other than a
physician's office where surgical, diagnostic and therapeutic services are
provided on an outpatient ambulatory basis
Appeal - ANSWER a special kind of complaint when a beneficiary or provider
disagrees with decision concerning health care services
Advance beneficiary notice - ANSWER a notice that a provider of care should
give to a Medicare beneficiary to sign if the care being provided may not be
considered medically necessary and Medicare would not pay for it
Ancillary services - ANSWER a hospital department, except a nursing unit,
that provides medical services such as diagnostic tests therapeutic procedures or
dispenses medical items
Assignment of benefits - ANSWER a written authorization from a policyholder
for the insurer to pay benefits directly to the care provider
Admitting physician - ANSWER the physician who signs the patient's
admission order to the hospital
UPDATED
Bad Debt - ANSWER an accounts receivable that is deemed uncollectable and
written off as a credit loss, even though the patient is able to pay
Appropriate care - ANSWER a diagnostic or treatment measure whose
expected health benefit exceeds its expected health risk by a wide enough
margin to justify the measure
Access - ANSWER the capability of the patient to obtain medical care
Elements that affect access - ANSWER • Availability of health services
• Acceptability to the patient
• Facility location
• Transportation
• Hours
• Affordability of care
Attending Physician - ANSWER the doctor who orders outpatient procedures
or directs the patient's care during an inpatient stay
Authorization - ANSWER Approval from an insurance company for a service
that is an agreement to pay
Admission Date - ANSWER the date when the patient was first admitted to the
hospital for a specific visit
Adjustor - ANSWER insurance company representative
, Acute inpatient care - ANSWER a level of care given to patients with acute
illness or injury. Acute care is typically short term.
Admission authorization - ANSWER third party payer notification of an
emergent/urgent inpatient admission within a payers predetermined time
Administrative costs - ANSWER costs associated with the production and
forwarding of a bill for services, which can include registration, utilization
review, coding, billing and collection costs
Add-ons - ANSWER patients who are scheduled for services less than 24 hours
before the actual service time
Ambulatory surgical center - ANSWER a freestanding institution, other than a
physician's office where surgical, diagnostic and therapeutic services are
provided on an outpatient ambulatory basis
Appeal - ANSWER a special kind of complaint when a beneficiary or provider
disagrees with decision concerning health care services
Advance beneficiary notice - ANSWER a notice that a provider of care should
give to a Medicare beneficiary to sign if the care being provided may not be
considered medically necessary and Medicare would not pay for it
Ancillary services - ANSWER a hospital department, except a nursing unit,
that provides medical services such as diagnostic tests therapeutic procedures or
dispenses medical items
Assignment of benefits - ANSWER a written authorization from a policyholder
for the insurer to pay benefits directly to the care provider
Admitting physician - ANSWER the physician who signs the patient's
admission order to the hospital
