ACMA CERTIFICATION 2026 EXAMINER QUESTIONS
AND ANSWERS SURE A+
✔✔Participating (PAR) or Non-participating - ✔✔Designation for providers that means
the organization or individual agrees to accept assignment for all services furnished to
the insured patient (or not). By accepting assignment, the provider agrees to accept the
amount approved by the insurer as total payment for covered services
✔✔Patient Protection and Affordable Care Act (PPACA or ACA) - ✔✔Aimed at
decreasing the number of uninsured Americans and reducing the overall costs of health
care. Provides a number of incentives, including subsidies, tax credits and fees, to
employers and uninsured individuals in order to increase insurance coverage
✔✔Patient Safety Indicators (PSIs) - ✔✔Set of indicators providing information on
potential in-hospital complications and adverse events following surgeries, procedures,
and childbirth
✔✔Patient Self-Determination Act (PSDA) of 1991 - ✔✔Federal law requiring
healthcare facilities that receive Medicare and Medicaid funds to inform patients of their
right to execute an advanced directive concerning their end of life care
✔✔Pay-for-performance - ✔✔Providing financial incentives to clinicians who achieve,
improve, or exceed their performance on specified quality and cost measures as well as
other benchmarks
, ✔✔Percutaneous Endoscopic Gastronomy Tube (PEG) - ✔✔Tube for administering
liquid feedings, hydration, or medications inserted directly into the stomach through the
abdominal wall
✔✔Performance Improvement Plan (PIP) - ✔✔Plan that establishes a systematic
approach to achieving quality measures in performance, process, analysis, or service
✔✔Peripherally Inserted Central Catheter (PICC) - ✔✔Long-term type catheter that is
inserted peripherally. Typically placed for infusions of fluids or medications in the home
or at a Skilled Nursing Facility (SNF)
✔✔Physician Advisor - ✔✔Medical doctor who serves per the hospital utilization
management plan to perform secondary UM reviews and/or address car progression
and UM concerns with care providers and hospital leaders
✔✔Post-Acute Care - ✔✔Services and facilities arranged to provide care upon
transition from the acute level of care. May include home health, hospice, assisted
living, and skilled nursing facilities
✔✔Potential Avoidable Days - ✔✔potentially preventable occurrences or events during
a patients stay that cause an increase in the patient's length of stay or produce a delay
in discharge
✔✔Nondurable Power of Attorney (POA) - ✔✔Written authorization to represent or act
on another's behalf in private affairs, business or some other legal matter. Ends when
the person who makes them loses mental capacity
✔✔Durable Power of Attorney - ✔✔Written authorization to represent or act on
another's behalf in private affairs, business or some other legal matter that stays in
effect if the person becomes incapacitated or unable to handle matters on your own
✔✔Pre-Admission Screening and Resident Review (PASRR) - ✔✔Screening for
individuals who require a level 2 and are being considered for admission to a nursing
facility or are already residents and have a significant change in their physical or mental
condition or hospitalization within the last 2 years
✔✔Prior Authorization - ✔✔Cost containment process of obtaining approval prior to the
receiving services
✔✔Project Boost Risk Assessment - ✔✔A risk assessment tool kit developed by the
Society for Hospital Medicine
✔✔Quality Improvement Organization (QIO) - ✔✔Group of health quality experts,
clinicians, and consumers organized to improve the care delivered to people with
Medicare
AND ANSWERS SURE A+
✔✔Participating (PAR) or Non-participating - ✔✔Designation for providers that means
the organization or individual agrees to accept assignment for all services furnished to
the insured patient (or not). By accepting assignment, the provider agrees to accept the
amount approved by the insurer as total payment for covered services
✔✔Patient Protection and Affordable Care Act (PPACA or ACA) - ✔✔Aimed at
decreasing the number of uninsured Americans and reducing the overall costs of health
care. Provides a number of incentives, including subsidies, tax credits and fees, to
employers and uninsured individuals in order to increase insurance coverage
✔✔Patient Safety Indicators (PSIs) - ✔✔Set of indicators providing information on
potential in-hospital complications and adverse events following surgeries, procedures,
and childbirth
✔✔Patient Self-Determination Act (PSDA) of 1991 - ✔✔Federal law requiring
healthcare facilities that receive Medicare and Medicaid funds to inform patients of their
right to execute an advanced directive concerning their end of life care
✔✔Pay-for-performance - ✔✔Providing financial incentives to clinicians who achieve,
improve, or exceed their performance on specified quality and cost measures as well as
other benchmarks
, ✔✔Percutaneous Endoscopic Gastronomy Tube (PEG) - ✔✔Tube for administering
liquid feedings, hydration, or medications inserted directly into the stomach through the
abdominal wall
✔✔Performance Improvement Plan (PIP) - ✔✔Plan that establishes a systematic
approach to achieving quality measures in performance, process, analysis, or service
✔✔Peripherally Inserted Central Catheter (PICC) - ✔✔Long-term type catheter that is
inserted peripherally. Typically placed for infusions of fluids or medications in the home
or at a Skilled Nursing Facility (SNF)
✔✔Physician Advisor - ✔✔Medical doctor who serves per the hospital utilization
management plan to perform secondary UM reviews and/or address car progression
and UM concerns with care providers and hospital leaders
✔✔Post-Acute Care - ✔✔Services and facilities arranged to provide care upon
transition from the acute level of care. May include home health, hospice, assisted
living, and skilled nursing facilities
✔✔Potential Avoidable Days - ✔✔potentially preventable occurrences or events during
a patients stay that cause an increase in the patient's length of stay or produce a delay
in discharge
✔✔Nondurable Power of Attorney (POA) - ✔✔Written authorization to represent or act
on another's behalf in private affairs, business or some other legal matter. Ends when
the person who makes them loses mental capacity
✔✔Durable Power of Attorney - ✔✔Written authorization to represent or act on
another's behalf in private affairs, business or some other legal matter that stays in
effect if the person becomes incapacitated or unable to handle matters on your own
✔✔Pre-Admission Screening and Resident Review (PASRR) - ✔✔Screening for
individuals who require a level 2 and are being considered for admission to a nursing
facility or are already residents and have a significant change in their physical or mental
condition or hospitalization within the last 2 years
✔✔Prior Authorization - ✔✔Cost containment process of obtaining approval prior to the
receiving services
✔✔Project Boost Risk Assessment - ✔✔A risk assessment tool kit developed by the
Society for Hospital Medicine
✔✔Quality Improvement Organization (QIO) - ✔✔Group of health quality experts,
clinicians, and consumers organized to improve the care delivered to people with
Medicare
