CHAA 2025 STUDY GUIDE – TERMS
LATEST UPDATE.
Accreditation - CORRECT ANSWER Self-assessment and external peer assessment process used by
healthcare organizations to accurately assess their level of performance.
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 healthcare delivered to patients experiencing acute
illness or trauma. Acute care is generally short-term (<30 days).
Advance Beneficiary Notice (ABN) - CORRECT ANSWER Written notice issued to a fee-for-service
(Original Medicare) beneficiary before furnishing items or services that are usually covered by Medicare
but are not expected to be paid in a specific instance for certain reasons, such as lack of medical
necessity.
Advance Directive - CORRECT ANSWER Known as medical directive, healthcare directive or living will. A
legal doc in which a person has outlined what they would like done if they are no longer able to make
decisions for themselves due to incapacity or illness.
Ambulatory Services/Same-Day Surgery - CORRECT ANSWER patient recieves surgical treatment and is
discharged from facility within 4-6 hrs of procedures
Ancillary Services - CORRECT ANSWER Physician refers patients for scheduled and non-scheduled
services such as radiology, laboratory, and/or other services that are performed in a hospital or clinic
setting. Patients leave the facility once the services are completed.
Anti-Kickback Statue - CORRECT ANSWER Anti-fraud federal criminal statute that prohibits offering or
exchange of anything of value in exchange for healthcare business referrals, including cash, rent,
expensive hotel stays, etc.
, Authorization Requirement - CORRECT ANSWER Certain services need authorizations while other
procedures might not. Some insurance companies require a CPT code, so make sure you have that
available.
Batch Processing - CORRECT ANSWER Series of jobs in a computer program w/o manual intervention; it
is used to help maximize the use of computer resources and stabilize response time by performing
system-intensive work during hours when users are less likely to need access.
Carve Out - CORRECT ANSWER The choice to separately purchase a service, which is typically part of an
HMO plan. Pre-certifications/pre-authorization is often required for these services.
Case Management - CORRECT ANSWER Coordination of services to help meet a patient's healthcare
needs.
Centers for Medicare and Medicaid Services (CMS) - CORRECT ANSWER Federal agency under the
Department of Health and Human Services (HHS) that administers Medicare and partners with state
governments for administration of Medicaid and other programs, including CHIP.
CHAMPVA - CORRECT ANSWER The Civilian Health and Medical Program for the Veterans Administration
is an insurance program for the families of veterans.
Charity Care - CORRECT ANSWER Free or discounted medical care provided to patients who do not have
the ability to pay for all or a part of medical costs due to limited income or financial hardship.
Co-Insurance - CORRECT ANSWER the percentage of the bill for services that the policy holder must pay
after deductible has been met.
Condition code 44 - CORRECT ANSWER When a Medicare patient is admitted to a hospital as an
inpatient but, upon internal review, the hospital determines the services did not meet inpatient criteria
and the admission is changed to observation. This rule has become informally known as "condition code
44."
LATEST UPDATE.
Accreditation - CORRECT ANSWER Self-assessment and external peer assessment process used by
healthcare organizations to accurately assess their level of performance.
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 healthcare delivered to patients experiencing acute
illness or trauma. Acute care is generally short-term (<30 days).
Advance Beneficiary Notice (ABN) - CORRECT ANSWER Written notice issued to a fee-for-service
(Original Medicare) beneficiary before furnishing items or services that are usually covered by Medicare
but are not expected to be paid in a specific instance for certain reasons, such as lack of medical
necessity.
Advance Directive - CORRECT ANSWER Known as medical directive, healthcare directive or living will. A
legal doc in which a person has outlined what they would like done if they are no longer able to make
decisions for themselves due to incapacity or illness.
Ambulatory Services/Same-Day Surgery - CORRECT ANSWER patient recieves surgical treatment and is
discharged from facility within 4-6 hrs of procedures
Ancillary Services - CORRECT ANSWER Physician refers patients for scheduled and non-scheduled
services such as radiology, laboratory, and/or other services that are performed in a hospital or clinic
setting. Patients leave the facility once the services are completed.
Anti-Kickback Statue - CORRECT ANSWER Anti-fraud federal criminal statute that prohibits offering or
exchange of anything of value in exchange for healthcare business referrals, including cash, rent,
expensive hotel stays, etc.
, Authorization Requirement - CORRECT ANSWER Certain services need authorizations while other
procedures might not. Some insurance companies require a CPT code, so make sure you have that
available.
Batch Processing - CORRECT ANSWER Series of jobs in a computer program w/o manual intervention; it
is used to help maximize the use of computer resources and stabilize response time by performing
system-intensive work during hours when users are less likely to need access.
Carve Out - CORRECT ANSWER The choice to separately purchase a service, which is typically part of an
HMO plan. Pre-certifications/pre-authorization is often required for these services.
Case Management - CORRECT ANSWER Coordination of services to help meet a patient's healthcare
needs.
Centers for Medicare and Medicaid Services (CMS) - CORRECT ANSWER Federal agency under the
Department of Health and Human Services (HHS) that administers Medicare and partners with state
governments for administration of Medicaid and other programs, including CHIP.
CHAMPVA - CORRECT ANSWER The Civilian Health and Medical Program for the Veterans Administration
is an insurance program for the families of veterans.
Charity Care - CORRECT ANSWER Free or discounted medical care provided to patients who do not have
the ability to pay for all or a part of medical costs due to limited income or financial hardship.
Co-Insurance - CORRECT ANSWER the percentage of the bill for services that the policy holder must pay
after deductible has been met.
Condition code 44 - CORRECT ANSWER When a Medicare patient is admitted to a hospital as an
inpatient but, upon internal review, the hospital determines the services did not meet inpatient criteria
and the admission is changed to observation. This rule has become informally known as "condition code
44."
