CAHIMS - Unit 3 Questions and Answers Updated 2026

CAHIMS - Unit 3 Questions and
Answers Updated 2026
_____BisBtheBrecordingBofBallBtreatments,Bdiagnoses,BandBotherBmedicalBservices.BItBisBcomm
onlyBdoneBelectronicallyBbutBmayBbeBdoneBonBpaper.B-BAnswerchargeBcapture



____BisBtheBprocessBofBtranslatingBtreatments,Bdiagnoses,BandBotherBmedicalBservicesBintoBes
tablishedBalphanumericBcodesBsoBthatBtheyBcanBbeBsubmittedBasBpartBofBaBclaim.B-
BAnswercoding



WhenBaBhealthcareBorganizationBsuchBasBaBphysicianBgroupBreceivesBaBper-
headBfeeBforBeachBindividualBenrolledBinBaBplan,BitBisBknownB_____.BABcapitationBpaymentBr
eflectsBtheB____BofBitsBenrollees.BABmedicalBserviceBorBconditionBthatBisBexemptedBfromBaBc
apitationBplanBisBcalledBa/anB_____.BIfBaBphysicianBorBphysicianBgroupBreceivesBtheBpayment
BwhetherBorBnotBtheBindividualBenrolledBinBtheBplanBseeksBmedicalBservices,BitBrepresentsBa
B____Bmode.B-BAnswerCAPITATION;healthBstatus;carveBout;CAPITATION



ABphysicianBorganizationBcontractsBwithBaBhealthBmaintenanceBorganizationB(HMO)BtoBprovide
BservicesBtoBitsBsubscribers.BTheBphysicianBorganizationBreceivesBaBflatBmonthlyBfeeBforBeach
BpatientBenrolledBinBtheBHMO.BNoBadditionalBpaymentsBareBmadeBforBcomplicationsBorBhigh
er-than-expectedBusageBofBsomeBhealthcareBservices.BThisBarrangementBisBknownBasBaB_____

fee-for-service

bundledBservice

preventionBmodel

capitationBmodelB-BAnswercapitationBmodel



ProvidesBforBcontinuedBhealthcareBcoverageBafterBemploymentBisBterminatedB-
BAnswerConsolidatedBOmnibusBBudgetBReconciliationBActBofB1985B(COBRA)



LimitsBexclusionsBbasedBonBpreexistingBconditions;BmandatesBelectronicBmedicalBrecordsB(EMR
);BmandatesBprivacyBrequirementsBforBpatientBinformationB-
BAnswerHealthBInsuranceBPortabilityBandBAccountabilityBActB(HIPAA)



HITECHBisBcontainedBwithinB______B-
BAnswerAmericanBReinvestmentBandBRecoveryBActBofB2009B(ARRA)

,PromotesBmeaningfulBuseBofBhealthBinformationBtechnologyB-
BAnswerHealthBInformationBTechnologyBforBEconomicBandBClinicalBHealthBActB(HITECHBAct)



FocusesBonBmakingBhealthBinsuranceBmoreBaffordableBforBAmericansBandBincreasingBtheBnum
berBofBthoseBwithBhealthBinsuranceB-
BAnswerHealthBCareBandBEducationBReconciliationBActBofB2010B(AffordableBHealthcareBAct)



Lester'sBhealthBinsuranceBpaysBforBcolonoscopiesBasBaBscreeningBtoolBforBcolonBcancer.BWhat
BtypeBofBscreeningBisBdescribed?

PrimaryBprevention

SecondaryBprevention

TertiaryBprevention

PerioperativeBtreatmentB-BAnswerprimaryBprevention



WhatBareBbundledBpaymentsBassociatedBwith?

PrimaryBprevention

ActuarialBresearch

EpisodesBofBcare

CapitationBmodelsB-BAnswerEpisodesBofBcare



TheBPhysiciansBGroupBofBArizonaBisBanBindependentBpracticeBassociationB(IPA)BthatBcontractsB
withBanBHMOBtoBprovideBmedicalBservicesBtoBtheBmembersBofBtheBgroup.BTheBphysiciansBgr
oupBisBreimbursedBaBflatByearlyBfeeBforBeveryBindividualBinBtheBHMOBregardlessBofBhowBmu
chBanBindividualBusesBtheBplan.BWhatBtypeBofBfinancingBmodelBisBdescribed?

Capitation

Fee-for-service

PrimaryBcare

ABbundledBpaymentBmodelB-BAnswerCapitation



____BoccursBwhenBtheBaccountBisBsettledBwithBtheBpatient.BCopays,Bcoinsurance,BandBdeduct
iblesBmayBneedBtoBbeBtakenBintoBaccount.BThisBmustBbeBdoneBbeforeBaBclaimBcanBbeBsubmi
tted.B-BAnswerfinalBsettlement



WhichBofBtheBfollowingBisBnotBtrueBofBMedicaid?

,BMedicaidBsometimesBhasBaBcopay.

BMedicaidBoffersBaBfairlyBwideBrangeBofBservices.

BMedicaidBhasBanBincomeBrequirement.

BMedicaidBisBentirelyBfundedBbyBtheBfederalBgovernment.B-
BAnswerMedicaidBisBentirelyBfundedBbyBtheBfederalBgovernment.



JodyBcanBchooseBbetweenBaBvarietyBofBprivateBhealthBproviders.BHowever,BherBmedicalBexpe
nsesBareBpaidBforBbyBtheBgovernment.BWhatBkindBofBsystemBisBJodyBparticipatingBin?

BMultipleBpayer

BSingleBpayer

BIndemnity

BHealthBmaintenanceBorganizationB(HMO)B-BAnswersingleBpayer



WhichBofBtheBfollowingBisBaBcommonBcriticismBofBtheBcapitatedBmodel?

BItBisBmoreBexpensiveBthanBaBfee-for-serviceBmodel.

BSickerBpatientsBareBdeniedBaccessBtoBtheBhealthBplan.

BItBisBimpossibleBtoBpredictBtheBfutureBhealthBofBpatients.

BPhysiciansBtendBtoBuseBmoreBexpensiveBtreatments.B-
BAnswerSickerBpatientsBareBdeniedBaccessBtoBtheBhealthBplan.



WhereBwasBmostBhealthcareBprovidedBinBtheBlateB19thBandBearlyB20thBcenturies?

BInBhospitals

BInBclinicsBwhereBanBemployeeBworked

BAtBpatients'BorBdoctors'Bhomes

BAtBsitesBsponsoredBbyBtheBemployee'sBinsuranceBcompanyB-
BAnswerAtBpatients'BorBdoctors'Bhomes



WhichBofBtheBfollowingBisBconsideredBaBcommonBstrengthBofBmanagedBcareBorganizations?

NoBdeductiblesBforBpatients

TheBabilityBforBtheBpatientBtoBchooseBanyBphysician,BincludingBaBspecialist

WellnessBinitiatives

LackBofBtheBPCPBfunctionB-BAnswerwellnessBinitiatives

, WhichBofBtheBfollowingBisBnotBaBfeatureBofBaBpoint-of-serviceB(POS)Bplan?

ReferralsBtoBout-of-planBprovidersBalwaysBavailableBbutBreimbursedBatBaBlowerBrate

ReferralsBusuallyBgivenBforBin-networkBprovidersBonly

UsesBmultipleBhealthBcareBmodels

UsesBaBPCPBandBrequiresBallBservicesBtoBbeBthroughBtheBPCPB-BAnswerReferralsBtoBout-of-
planBprovidersBalwaysBavailableBbutBreimbursedBatBaBlowerBrate



EllieBisBaBhealthyB35-year-
oldBownerBofBaBsuccessfulBsmallBbusiness.BSheBisBtheBonlyBemployeeBofBherBbusiness.BSheBn
eedsBhealthBinsurance.BSheBwouldBmostBlikelyBapplyBforB

Medicaid

aBprivateBnongroupBinsuranceBplan

Medicare

groupBinsurance.B-BAnsweraBprivateBnongroupBinsuranceBplan



WhichBofBtheBfollowingBisBnotBaBkeyBroleBofBtheBfederalBgovernmentBinBhealthBcare?

BLawmaker

BProviderBofBhealthcareBservices

BPayerBforBhealthcareBservices

BOriginatorBofBself-fundedBplansBforBbusinessB-BAnswerOriginatorBofBself-
fundedBplansBforBbusiness



WhichBofBtheBfollowingBisBnotBaBreasonBthatBuninsuredBindividualsBaffectBtheBcostBofBhealth
care?

BTheyBseekBandBreceiveBlessBpreventiveBcare.

BTheyBareBusuallyBelderly.

BTheyBseekBtreatmentBwhenBaBdiseaseBisBmoreBadvanced.

BTheyBreceiveBlessBtherapeuticBcare.B-
BAnswerTheyBseekBtreatmentBwhenBaBdiseaseBisBmoreBadvanced.



Dr.BKomarBoperatesBherBownBfamilyBmedicalBpractice.BSheBacceptsBonlyBaBcoupleBofBdifferent
BinsuranceBplans,BandBallBofBherBmedicalBrecordsBareBonBpaper.BSheBordersBtestsBandBproce
duresBasBneededBwithoutBregardBtoBcostsBbecauseBsheBthinksBthatBtheBprofitBelementBisBaB