CHAA Certification Final Exam Study
Test.
Accepting Assignment - CORRECT ANSWER When a provider agrees to accept the allowable charges as
the full fee and cannot charge the patient the difference between the insurance payment and the
provider's normal fee.
Access - CORRECT ANSWER The Patient's ability to obtain medical care. The ease of access is determined
by such components as the availability of medical services and their acceptability to the patient, the
location of health care facilities, transportation, hours of operation and cost of care.
Account Number - CORRECT ANSWER A number assigned to each account. The number is used to
identify the account and all charges and payments received.
Acute Care - CORRECT ANSWER Medical attention given to patients with conditions of sudden onset that
demand urgent attention or care of limited duration when the patient's health and wellness would
deteriorate without treatment. The care is generally short-term rather than long-term or chronic care.
Acute Inpatient Care - CORRECT ANSWER A level of health care delivered to patients experiencing acute
illness or trauma. Acute care is generally short-term less than 30 days.
Add-Ons - CORRECT ANSWER Patients who are scheduled for services less than 24 hours in advance of
the actual service time.
Adjustor - CORRECT ANSWER Insurance company representative
Administrative Costs - CORRECT ANSWER Costs associated with creating and submitting a bill for
services, which could include, registration, utilization review, coding, billing, and collection expenses.
Admission Authorization - CORRECT ANSWER The process of third party payor notification of
urgent/emergent inpatient admission within specified time as determined by payors which is usually
within a 24 to 48 hour or next business day.
, Admission Date - CORRECT ANSWER The first date the patient entered the hospital for a specific visit.
Admitting Diagnosis - CORRECT ANSWER Word, phrase, International Classification of Disease (ICD9)
code used by the admitting physician to identify a condition or disease from which a patient suffers and
for which the patient needs or seeks medical care.
Admitting Physician - CORRECT ANSWER The physician who writes the order for the patient to be
admitted to the hospital. The physician must have admitting privileges at the facility providing the health
care services.
Advance Beneficiary Notice (ABN) - CORRECT ANSWER A notice that a care provider should give a
Medicare beneficiary to sign if the services being provided may not be considered medically necessary
and Medicare may not pay for them. The advanced beneficiary notice (ABN) allows the beneficiary to
make a informed decision prior to services whether or not he/she wishes to receive services. ABNs are
not routinely given to emergency department patients.
Advanced Directives - CORRECT ANSWER An advance directive is a written instruction relating to the
provision of health care when a patient is incapacitated. It could include appointing someone to make
medical decisions, a state expressing the patients wishes about anatomical gifts (like organ donation),
and general statements about whether or not life-sustaining treatments should be withheld or
withdrawn.
Adverse Selection - CORRECT ANSWER Among applicants for a given group or individual program, the
tendency for those with an impaired health status, or who are prone to higher than average utilization
of benefits to be enrolled in disproportionate numbers and lower deductible plans.
Alias - CORRECT ANSWER An alias is a name by which the patient is also known as or formerly known as.
All patient Diagnosis Related Groups Assignment of Benefits (APDRG) - CORRECT ANSWER A prospective
hospital claims reimbursement system currently utilized by the federal government Medicaid program
and the states of New York and New Jersey. APDRGs were designed to describe the complete cross
section of patients seen in acute care hospitals. Approximately 639 APDRGs are defined according to the
principal diagnosis, secondary diagnoses, procedures, age, birth weight, sex, discharge status. Each
category has an established fixed reimbursement rate based on average cost of treatment within a
geographic area. APRDRG's were developed to quantify the difference in demographic
Test.
Accepting Assignment - CORRECT ANSWER When a provider agrees to accept the allowable charges as
the full fee and cannot charge the patient the difference between the insurance payment and the
provider's normal fee.
Access - CORRECT ANSWER The Patient's ability to obtain medical care. The ease of access is determined
by such components as the availability of medical services and their acceptability to the patient, the
location of health care facilities, transportation, hours of operation and cost of care.
Account Number - CORRECT ANSWER A number assigned to each account. The number is used to
identify the account and all charges and payments received.
Acute Care - CORRECT ANSWER Medical attention given to patients with conditions of sudden onset that
demand urgent attention or care of limited duration when the patient's health and wellness would
deteriorate without treatment. The care is generally short-term rather than long-term or chronic care.
Acute Inpatient Care - CORRECT ANSWER A level of health care delivered to patients experiencing acute
illness or trauma. Acute care is generally short-term less than 30 days.
Add-Ons - CORRECT ANSWER Patients who are scheduled for services less than 24 hours in advance of
the actual service time.
Adjustor - CORRECT ANSWER Insurance company representative
Administrative Costs - CORRECT ANSWER Costs associated with creating and submitting a bill for
services, which could include, registration, utilization review, coding, billing, and collection expenses.
Admission Authorization - CORRECT ANSWER The process of third party payor notification of
urgent/emergent inpatient admission within specified time as determined by payors which is usually
within a 24 to 48 hour or next business day.
, Admission Date - CORRECT ANSWER The first date the patient entered the hospital for a specific visit.
Admitting Diagnosis - CORRECT ANSWER Word, phrase, International Classification of Disease (ICD9)
code used by the admitting physician to identify a condition or disease from which a patient suffers and
for which the patient needs or seeks medical care.
Admitting Physician - CORRECT ANSWER The physician who writes the order for the patient to be
admitted to the hospital. The physician must have admitting privileges at the facility providing the health
care services.
Advance Beneficiary Notice (ABN) - CORRECT ANSWER A notice that a care provider should give a
Medicare beneficiary to sign if the services being provided may not be considered medically necessary
and Medicare may not pay for them. The advanced beneficiary notice (ABN) allows the beneficiary to
make a informed decision prior to services whether or not he/she wishes to receive services. ABNs are
not routinely given to emergency department patients.
Advanced Directives - CORRECT ANSWER An advance directive is a written instruction relating to the
provision of health care when a patient is incapacitated. It could include appointing someone to make
medical decisions, a state expressing the patients wishes about anatomical gifts (like organ donation),
and general statements about whether or not life-sustaining treatments should be withheld or
withdrawn.
Adverse Selection - CORRECT ANSWER Among applicants for a given group or individual program, the
tendency for those with an impaired health status, or who are prone to higher than average utilization
of benefits to be enrolled in disproportionate numbers and lower deductible plans.
Alias - CORRECT ANSWER An alias is a name by which the patient is also known as or formerly known as.
All patient Diagnosis Related Groups Assignment of Benefits (APDRG) - CORRECT ANSWER A prospective
hospital claims reimbursement system currently utilized by the federal government Medicaid program
and the states of New York and New Jersey. APDRGs were designed to describe the complete cross
section of patients seen in acute care hospitals. Approximately 639 APDRGs are defined according to the
principal diagnosis, secondary diagnoses, procedures, age, birth weight, sex, discharge status. Each
category has an established fixed reimbursement rate based on average cost of treatment within a
geographic area. APRDRG's were developed to quantify the difference in demographic
