CHAM Medicare
Exam Questions And Verified Answers
2026 Updated
⩥ Inpatient. Answer: term used when a patient is admitted to the hospital
w/ the expectation that the pt will stay for a period of 24 hrs or more
⩥ Medical Record Number. Answer: Unique number associated with
your name in the medical record
MRN
⩥ No Balance Billing Provision. Answer: provider contract clause which
states the provider agrees to accept the amount the plan pays as payment
in full not to bill the members/(except co-pays, coinsured deductibles)
⩥ Correct Coding Initiative. Answer: federal legislation that attempts to
eliminate unbundling or other inappropriate reporting of procedural
codes for professional medical services rendered to patients
CCI, Federal legislation that attempts to eliminate unbundling or other
inappropriate reporting of procedural codes for professional medical
services rendered to patients
⩥ Medigap Insurance. Answer: To pay for medical services and items
that Medicare does not cover and Medicare's coinsurance and
, deductibles, beneficiaries may purchase a supplemental insurance.
Private insurance designed to help pay for those amounts that are
typically the patients responsibility under Medicare.
⩥ Nurse Practitioner. Answer: RN usually with a bachelor’s degree who
has successfully completed additional training in a NP program at the
masters or doctoral level
⩥ Non-Availability Statement. Answer: certificate issued by a military
treatment facility that cannot provide needed care to TRICARE Standard
beneficiaries. This means the beneficiary can seek care from a civilian
provider and reimbursement will be approved. NAS certificates are not
required for emergency care.
⩥ Managed Care. Answer: Tries to balance the need for cost
containment with access and quality of service.
⩥ Master Patient Index. Answer: Is permanent, aka Enterprise MPI or
EMPI
⩥ MSP. Answer: Medicare Secondary Payer
It is important for the insurance billing specialist to determine whether a
patient's Medicare coverage is primary or secondary
Exam Questions And Verified Answers
2026 Updated
⩥ Inpatient. Answer: term used when a patient is admitted to the hospital
w/ the expectation that the pt will stay for a period of 24 hrs or more
⩥ Medical Record Number. Answer: Unique number associated with
your name in the medical record
MRN
⩥ No Balance Billing Provision. Answer: provider contract clause which
states the provider agrees to accept the amount the plan pays as payment
in full not to bill the members/(except co-pays, coinsured deductibles)
⩥ Correct Coding Initiative. Answer: federal legislation that attempts to
eliminate unbundling or other inappropriate reporting of procedural
codes for professional medical services rendered to patients
CCI, Federal legislation that attempts to eliminate unbundling or other
inappropriate reporting of procedural codes for professional medical
services rendered to patients
⩥ Medigap Insurance. Answer: To pay for medical services and items
that Medicare does not cover and Medicare's coinsurance and
, deductibles, beneficiaries may purchase a supplemental insurance.
Private insurance designed to help pay for those amounts that are
typically the patients responsibility under Medicare.
⩥ Nurse Practitioner. Answer: RN usually with a bachelor’s degree who
has successfully completed additional training in a NP program at the
masters or doctoral level
⩥ Non-Availability Statement. Answer: certificate issued by a military
treatment facility that cannot provide needed care to TRICARE Standard
beneficiaries. This means the beneficiary can seek care from a civilian
provider and reimbursement will be approved. NAS certificates are not
required for emergency care.
⩥ Managed Care. Answer: Tries to balance the need for cost
containment with access and quality of service.
⩥ Master Patient Index. Answer: Is permanent, aka Enterprise MPI or
EMPI
⩥ MSP. Answer: Medicare Secondary Payer
It is important for the insurance billing specialist to determine whether a
patient's Medicare coverage is primary or secondary
