CHAA Exam Study Guide
Questions & Correct Answers
A financial counselor/Financial Assistance - CORRECT ANSWER In accordance with Section 501(r)
regulations through the Affordable Care Act, a hospital must establish a written financial assistance
policy and make it available to patients.
Batch Processing - CORRECT ANSWER Execution of a series of jobs in a computer program without
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 require access.
Unlike real-time transactions, jobs executed in batch are not available for users to view until after the
batch is run
A Valid Physician Order - CORRECT ANSWER Legibility Patient name Date (must be within specified
timeline - 30 days or as defined by state statute and/or facility policy) Test or therapy ordered Diagnosis,
signs or symptoms Physician signature
Patient Contact Center - CORRECT ANSWER A central point in an organization from which all customer
contacts are managed, including scheduling, pre-registration, pre-verification, prior authorization,
functions, etc.
Pricing Transparency - CORRECT ANSWER In healthcare, readily available information on the price of
healthcare services that, together with other information, helps define the value of those services and
enables patients and other care purchasers to identify, compare and choose providers that offer the
desired level of value.
Propensity to Pay - CORRECT ANSWER A means to evaluate payment risk, determine the most
appropriate collection policy and initiate financial counseling discussions. Based on a scoring algorithm,
programs can predict likelihood of payment. Those with a history of bad debt can be adjusted or
forwarded to collections at the earliest point possible
Access Keys - CORRECT ANSWER NAHAM has developed a series of guidelines that identify performance
criteria, explain how to measure them and provide Good/Better/Best benchmarks for facilities to
measure. These are called:
,Ambulatory Payment Classifications (APCs) - CORRECT ANSWER "Codes billed for outpatient services
preformed at a hospital. is calculated based on the national average cost (operating and capital) of the
hospitals"
Authorization - CORRECT ANSWER means a determination required under a health benefits plan, which
based on the information provided, satisfies the requirements under the member's health benefits plan
for medical necessity
Benefits for Automated Quality Assurance - CORRECT ANSWER 100% of registration audited, patients
access associated receive feedback on errors and can self correct, Errors corrected earlier in the revenue
cycle, and clean data before the bill drops.
BIRTHDAY RULE - CORRECT ANSWER According to the birthday rule, the primary plan for a child is the
health plan of the parent whose birthday comes first in the calendar year. Remember this is the date, not
the year. If both birthdays fall on the same day, then the plan that has been in effect longer is primary.
CMS 1450 (UB-04) (UB-92) - CORRECT ANSWER a federal directive requiring a hospital to follow specific
billing procedures, itemizing all services included and billed for on each invoice. Use by hospitals, skilled
nursing facilities, home health agencies, community mental health facilities,
Minimum Necessary Standard - CORRECT ANSWER people should only access, use or disclose the health
information that is minimally necessary to accomplish a given task or purpose.
Coordination of benefits (COB) - CORRECT ANSWER is a way of determining the order in which benefits
are paid, and the amounts that are payable, when a patient is covered by more than one health plan.
(HCAHPS) Hospital Consumer Assessment of Healthcare Providers - CORRECT ANSWER Also known as
Hospital CAHPS, it stands for Hospital Consumer Assessment of Healthcare Providers and Systems and is
a standardized survey of hospital patients that will capture patients' unique perspectives on hospital care
for the purpose of providing the public with comparable information on hospital quality.
Co-pay - CORRECT ANSWER Is used by physicians and other clinicians. It is a fixed amount that the
beneficiary pays for healthcare services, regardless of the actual charge; the amount is designated by an
insurer as the patient's responsibility.
, Critical Data Elements (CDEs) - CORRECT ANSWER Commonly entered errors
Current Procedural Terminology (CPT) - CORRECT ANSWER codes, which are used for coding procedures
is used to classify services provided by physicians, hospitals and ambulatory surgery centers
Exclusions - CORRECT ANSWER Certain procedures are excluded from the plan. Asking the insurance
company will let you know what services are not included and covered in the plan.
Financial counseling/Financial investigation - CORRECT ANSWER Is a method through which the provider
identifies actual payment sources and alternatives for the patient to pay the bill
Form locator - CORRECT ANSWER is the name of the data fields on each of the uniform bills (i.e., UB-04).
The UB-04 has 81 numerically sequenced form locators, while the 1500 has 33 form locators.
Healthcare Common Procedure Coding Systems - CORRECT ANSWER "is used to classify items and
services provided in the delivery of healthcare. Level II codes used to classify non-physician services."
International Classification of Diseases, Ninth Revision, Clinical Modifications - CORRECT ANSWER Was
developed and implemented October 1, 2015. Classification system includes diseases, injuries and
procedures
Lifetime Maximum - CORRECT ANSWER Many payers have a calendar year and a lifetime maximum limit
on benefits paid. Once the maximum has been reached, the benefits have been exhausted. There are no
more funds available for coverage of any further services.
master patient index - CORRECT ANSWER "Is the primary patient tracking link and therefore considered
the most important resource in a healthcare facility. It's used to match patients being registered for care
to their medical record and minimize duplicate medical records"
Medical necessity - CORRECT ANSWER According to Medicare.gov, is defined as "healthcare services or
supplies needed to prevent, diagnose or treat an illness, injury, condition, disease or its symptoms and
that meet accepted standards of medicine."
