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HCCA Compliance Vocab with All Answers and Illustrations Given $11.49
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HCCA Compliance Vocab with All Answers and Illustrations Given
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HCCA Compliance Vocab with All Answers and Illustrations Given 2 Midnight Rule - Regulation included in the 2014 Medicare inpatient prospective payment rule. Established that inpatient admissions spanning at least two midnights qualify for Medicare Part A payments. Inpatient stays lasting ...

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  • January 29, 2025
  • 35
  • 2024/2025
  • Exam (elaborations)
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  • HCCA basic compliance

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HCCA Compliance Vocab with All
Answers and Illustrations Given

2 Midnight Rule - ✔✔Regulation included in the 2014 Medicare inpatient

prospective payment rule. Established that inpatient admissions spanning at

least two midnights qualify for Medicare Part A payments. Inpatient stays

lasting fewer than two midnights must be treated and billed as outpatient

services.

340B Pricing Program - ✔✔A federal program requiring drug manufacturers to

provide outpatient drugs to eligible health care organizations/covered entities

at significantly reduced prices.

Academic Research Organization (ARO) - ✔✔An academic institution that

performs or manages clinical research services usually by partnering with a

research sponsor.

Adjusted Average per Capita Cost (AAPCC) - ✔✔CMS/HCFA's best estimate for

the amount of money it costs to care for Medicare recipients under fee-for-

services Medicare in a given area. The AAPCC is made up of 142 different rate

cells; 140 of them are factored for age, sex, Medicaid eligibility, Institutional




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,status, working ages, and whether a person has both Part A and Part B of

Medicare. The 2 remaining cells are for individuals with end stage renal disease.

Adjusted Community Rate (ACR) - ✔✔Under the ACA, insurers can't raise

premiums based on health status, medical claims, gender, or most of the other

factors that they had previously used to determine rates prior to ACA

implementation.

Advance Beneficiary Notice (ABN) - ✔✔A waiver signed by a patient confirming

the patient's understanding that certain provided services may not be

reimbursable under Medicare and therefore are the patient's responsibility.

Advanced Medical Technology Association (Advamed) - ✔✔Medical device

trade association.

Adverse Drug Experience (ADE) - ✔✔Any adverse event associated with the use

of a drug in humans, whether or not considered drug-related, including the

following: An adverse event occurring in the course of the use of a drug product

in professional practice; an adverse event occurring from drug overdose

whether accidental or intentional; an adverse event occurring from drug abuse;

an adverse event occurring from drug withdrawal; and any failure of expected

pharmacological action.

Adverse Drug Reaction (ADR) - ✔✔Injury caused by taking a medication.
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,Adverse Event (Research) (AE) - ✔✔Used broadly to mean any untoward or

unfavorable medical occurrence in a human subject, including any abnormal

sign, symptom, or disease, temporally associated with the subject's

participation in research, whether or not considered related to the subject's

participation in the research. Adverse events encompass both physical and

psychological harms.

Affiliated Covered Entity (ACE) - ✔✔Under HIPAA, legally separate covered

entities under common ownership or control have an option to be treated as a

single legal entity by choosing to designate as ACE. This enables the entities to

share information in a way that would otherwise be impermissible (use vs.

disclosure).

Agency for Healthcare Research and Quality (AHRQ) - ✔✔Agency within the

Department of Health and Human Services, whose mission is to produce

evidence to make health care safer, higher quality, more accessible, equitable,

and affordable, and to work within HHS and other partners to make sure that

the evidence is understood and used.

Ambulatory Care Center (ACC) - ✔✔Medical provide with services aimed at one-

day surgical patients and non-surgical outpatients. Patients treated in ACCs

include pediatric, adolescent, adult and geriatric.
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, Ambulatory Patient Class (APC) - ✔✔Method used to pay hospitals and surgery

centers for outpatient services using a Prospective Payment System (PPS). Each

service is assigned to various APC categories.

Ambulatory Patient Groups (APG) - ✔✔A Medicare patient classification system

designed to explain the amount and types of resources consumed in an

ambulatory visit. There are 290 APGs in the current version (Version 2.0) and

they encompass the full range of services delivered in the ambulatory setting,

including same day surgery units, hospital emergency rooms and outpatient

clinics.

Ambulatory Surgery Center (ASC) - ✔✔Medical facility providing same-day

surgical care.

American College of Healthcare Executives (ACHE) - ✔✔Professional society of

healthcare executives who lead hospitals, health systems, and other healthcare

organizations.

American College of Professional Coders (AAPC) - ✔✔Professional association

that provides education and certification to medical coders.




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