CHAA 2024 STUDY GUIDE QUESTIONS V V V V
WITH CORRECT ANSWERS
V V V
A V financial V counselor/Financial V Assistance V - V Correct V Answer V - V In V accordance
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V with V Section V 501(r) V regulations V through V the V Affordable V Care V Act, V a V hospital
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V must V establish V a V written V financial V assistance V policy V and V make V it V available V to
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V patients.
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Batch V Processing V - V Correct V Answer V - V Execution V of V a V series V of V jobs V in V a
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V computer V program V without V manual V intervention; V it V is V used V to V help V maximize
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V the V use V of V computer V resources V and V stabilize V response V time V by V performing
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V system-intensive V work V during V hours V when V users V are V less V likely V to V require
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V access. V Unlike V real-time V transactions, V jobs V executed V in V batch V are V not
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V available V for V users V to V view V until V after V the V batch V is V run
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A V Valid V Physician V Order V - V Correct V Answer V - V Legibility V Patient V name V Date
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V (must V be V within V specified V timeline V - V 30 V days V or V as V defined V by V state V statute
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V and/or V facility V policy) V Test V or V therapy V ordered V Diagnosis, V signs V or V symptoms
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V Physician V signature
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Patient V Contact V Center V - V Correct V Answer V - V A V central V point V in V an V organization
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V from V which V all V customer V contacts V are V managed, V including V scheduling, V pre-
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registration, V pre-verification, V prior V authorization, V functions, V etc.
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Pricing V Transparency V - V Correct V Answer V - V In V healthcare, V readily V available
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V information V on V the V price V of V healthcare V services V that, V together V with V other
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V information, V helps V define V the V value V of V those V services V and V enables V patients
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V and V other V care V purchasers V to V identify, V compare V and V choose V providers V that
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V offer V the V desired V level V of V value.
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Propensity V to V Pay V - V Correct V Answer V - V A V means V to V evaluate V payment V risk,
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V determine V the V most V appropriate V collection V policy V and V initiate V financial
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V counseling V discussions. V Based V on V a V scoring V algorithm, V programs V can V predict
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V likelihood V of V payment. V Those V with V a V history V of V bad V debt V can V be V adjusted V or
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V forwarded V to V collections V at V the V earliest V point V possible
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Access V Keys V - V Correct V Answer V - V NAHAM V has V developed V a V series V of
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V guidelines V that V identify V performance V criteria, V explain V how V to V measure V them
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V and V provide V Good/Better/Best V benchmarks V for V facilities V to V measure. V These
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V are V called:
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,Ambulatory V Payment V Classifications V (APCs) V - V Correct V Answer V - V "Codes V billed
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V for V outpatient V services V preformed V at V a V hospital. V is V calculated V based V on V the
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V national V average V cost V (operating V and V capital) V of V the V hospitals"
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Authorization V - V Correct V Answer V - V means V a V determination V required V under V a
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V health V benefits V plan, V which V based V on V the V information V provided, V satisfies V the
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V requirements V under V the V member's V health V benefits V plan V for V medical V necessity
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Benefits V for V Automated V Quality V Assurance V - V Correct V Answer V - V 100% V of
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V registration V audited, V patients V access V associated V receive V feedback V on V errors
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V and V can V self V correct, V Errors V corrected V earlier V in V the V revenue V cycle, V and
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V clean V data V before V the V bill V drops.
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BIRTHDAY V RULE V - V Correct V Answer V - V According V to V the V birthday V rule, V the
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V primary V plan V for V a V child V is V the V health V plan V of V the V parent V whose V birthday
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V comes V first V in V the V calendar V year. V Remember V this V is V the V date, V not V the V year.
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V If V both V birthdays V fall V on V the V same V day, V then V the V plan V that V has V been V in
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V effect V longer V is V primary.
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CMS V 1450 V (UB-04) V (UB-92) V - V Correct V Answer V - V a V federal V directive V requiring
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V a V hospital V to V follow V specific V billing V procedures, V itemizing V all V services V included
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V and V billed V for V on V each V invoice. V Use V by V hospitals, V skilled V nursing V facilities,
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V home V health V agencies, V community V mental V health V facilities,
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Minimum V Necessary V Standard V - V Correct V Answer V - V people V should V only V access,
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V use V or V disclose V the V health V information V that V is V minimally V necessary V to
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V accomplish V a V given V task V or V purpose.
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Coordination V of V benefits V (COB) V - V Correct V Answer V - V is V a V way V of V determining
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V the V order V in V which V benefits V are V paid, V and V the V amounts V that V are V payable,
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V when V a V patient V is V covered V by V more V than V one V health V plan.
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(HCAHPS) V Hospital V Consumer V Assessment V of V Healthcare V Providers V - V Correct
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V Answer V - V Also V known V as V Hospital V CAHPS, V it V stands V for V Hospital V Consumer
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V Assessment V of V Healthcare V Providers V and V Systems V and V is V a V standardized
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V survey V of V hospital V patients V that V will V capture V patients' V unique V perspectives V on
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V hospital V care V for V the V purpose V of V providing V the V public V with V comparable
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V information V on V hospital V quality.
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Co-pay V - V Correct V Answer V - V Is V used V by V physicians V and V other V clinicians. V It V is
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V a V fixed V amount V that V the V beneficiary V pays V for V healthcare V services, V regardless
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V of V the V actual V charge; V the V amount V is V designated V by V an V insurer V as V the
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V patient's V responsibility.
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Critical V Data V Elements V (CDEs) V - V Correct V Answer V - V Commonly V entered V errors
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, Current V Procedural V Terminology V (CPT) V - V Correct V Answer V - V codes, V which V are
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V used V for V coding V procedures V is V used V to V classify V services V provided V by
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V physicians, V hospitals V and V ambulatory V surgery V centers
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Exclusions V - V Correct V Answer V - V Certain V procedures V are V excluded V from V the
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V plan. V Asking V the V insurance V company V will V let V you V know V what V services V are
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V not V included V and V covered V in V the V plan.
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Financial V counseling/Financial V investigation V - V Correct V Answer V - V Is V a V method
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V through V which V the V provider V identifies V actual V payment V sources V and V alternatives
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V for V the V patient V to V pay V the V bill
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Form V locator V - V Correct V Answer V - V is V the V name V of V the V data V fields V on V each V of
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V the V uniform V bills V (i.e., V UB-04). V The V UB-04 V has V 81 V numerically V sequenced
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V form V locators, V while V the V 1500 V has V 33 V form V locators.
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Healthcare V Common V Procedure V Coding V Systems V - V Correct V Answer V - V "is V used
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V to V classify V items V and V services V provided V in V the V delivery V of V healthcare. V Level
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V II V codes V used V to V classify V non-physician V services."
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International V Classification V of V Diseases, V Ninth V Revision, V Clinical V Modifications V -
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V Correct V Answer V - V Was V developed V and V implemented V October V 1, V 2015.
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V Classification V system V includes V diseases, V injuries V and V procedures
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Lifetime V Maximum V - V Correct V Answer V - V Many V payers V have V a V calendar V year
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V and V a V lifetime V maximum V limit V on V benefits V paid. V Once V the V maximum V has
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V been V reached, V the V benefits V have V been V exhausted. V There V are V no V more V funds
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V available V for V coverage V of V any V further V services.
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master V patient V index V - V Correct V Answer V - V "Is V the V primary V patient V tracking V link
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V and V therefore V considered V the V most V important V resource V in V a V healthcare V facility.
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V It's V used V to V match V patients V being V registered V for V care V to V their V medical V record
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V and V minimize V duplicate V medical V records"
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Medical V necessity V - V Correct V Answer V - V According V to V Medicare.gov, V is V defined
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V as V "healthcare V services V or V supplies V needed V to V prevent, V diagnose V or V treat V an
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V illness, V injury, V condition, V disease V or V its V symptoms V and V that V meet V accepted
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V standards V of V medicine."
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Out-of-Pocket V Maximum V - V Correct V Answer V - V The V total V payments V toward t t t t t t t t t
V eligible V expenses V that V a V covered V person V funds V for V him/herself V and/or
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V dependents. V These V expenses V may V include V deductibles, V co-pays V and
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V coinsurance V as V defined V by V the V contract. V Once V this V limit V is V reached, V benefits
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V will V increase V to V 100 V percent V for V health V services V received V during V the V rest V of
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V that V calendar V or V policy V year. V Deductibles V may V or V may V not V be V included V in
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V out-of-pocket V limits.
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