AAHAM CRCS-P Study Guide Complete Questions & Answers!!

CRCS - ANSWER Certified Revenue Cycle Specialist AAHAM - ANSWER The American Association of Healthcare Administrative Management 1-Day Rule - ANSWER a requirement that all diagnostic or outpatient services furnished in connection with the principle admitting diagnosis within one day prior to the hospital admission are bundled with the inpatient services for Medicare billing. 3-Day Rule - ANSWER a requirement that all diagnostic or outpatient services furnished in connection with the principle admitting diagnosis within three days prior to the hospital admission are bundled with the inpatient services for Medicare billing. 5010A1 - ANSWER the American National Standards Institute transaction for a professional claim (the electronic equivalent of the CMS 15000), formerly the 837P 837I - ANSWER the American National Standards Institute transaction for an institutional claim; as a result of HIPAA, it is replacing the electronic UB-04. 837P - ANSWER a former American National Standards Institute transaction for a professional claim (the electronic equivalent of the CMS 15000), sincereplaced by the 5010A1. ABN - ANSWER the Advance Beneficiary Notice of Noncoverage; a form given to a Medicare beneficiary before services are furnished when a service does not meet or is not expected to meet medical necessity. abuse - ANSWER the misuse of a person, substance, service, or financial matter such that harm is caused; some forms of healthcare abuse include excessive or unwarranted use of technology, pharmaceuticals, and services; abuse of authority; and abuse of privacy, confidentiality, or duty to care; it also includes improper billing practices (like billing Medicare instead of primary insurer), increasing charges to Medicare beneficiaries but not to other patients, unbundling of services, and unnecessary transfers of patients. Accounts Receivable (AR) Days Outstanding - ANSWER an estimate, using average current revenues, of the days required to turn over the accou