CHAM EXAM QUESTIONS AND
ANSWERS GRADED A+ 2026
Indemnity - ANS Health ins plan in which pts may select dr or hosp and providers bill the pt
or their ins their normal fees for svc. coverage is usually provided for diag test or cond caused by
disease, illness, or injury. Routine screening and well vts are not always covered, also known as
"fee-for-service".
Joint Commission - ANS Which organization evaluates the policies, procedures, and outcomes
of care provided by hospitals?
This organization has been responsible for accrediting healthcare organizations since the middle
1950s and determines whether the organization is continually monitoring and improving the
quality of care they provide.
Inpatient - ANS term used when a patient is admitted to the hospital w/ the expectation that
the pt will stay for a period of 24 hrs or more
Medical Record Number - ANS Unique number associated with your name in the medical
record
MRN
No Balance Billing Provision - ANS provider contract clause which states the provider agrees
to accept the amount the plan pays as payment in full not to bill the members/(except co-pays,
coinsurand deductables)
@COPYRIGHT 2026/2027 ALL RIGHTS RESERVED
1
, Correct Coding Initiative - ANS federal legislation that attempts to eliminate unbundling or
other inappropriate reporting of procedural codes for professional medical services rendered to
patients
CCI, Federal legislation that attempts to eliminate unbundling or other inappropriate reporting
of procedural codes for professional medical services rendered to patients
Medigap Insurance - ANS To pay for medical services and items that Medicare does not cover
and Medicare's coinsurance and deductibles, beneficiaries may purchase a supplemental
insurance. Private insurance designed to help pay for those amounts that are typically the
patient;s responsibility under Medicare.
Nurse Practicioner - ANS RN usually with a bacholer's degree who has successfully completed
additional training in a NP program at the masters or doctoral level
Non-Availability Statement - ANS certificate issued by a military treatment facility that cannot
provide needed care to TRICARE Standard beneficiaries. This means the beneficiary can seek
care from a civilian provider and reimbursement will be approved. NAS certificates are not
required for emergency care.
Managed Care - ANS Tries to balance the need for cost containment with access and quality
of service.
Master Patient Index - ANS Is permanent,aka Enterprise MPI or EMPI
MSP - ANS Medicare Secondary Payer
It is important for the insurance billing specialist to determine whether a patient's Medicare
coverage is primary or secondary
Liability Insurance - ANS protects the insured party from being held liable for other's financial
losses
covers the insured if injuries or damages are caused to other people or their property.
@COPYRIGHT 2026/2027 ALL RIGHTS RESERVED
2
ANSWERS GRADED A+ 2026
Indemnity - ANS Health ins plan in which pts may select dr or hosp and providers bill the pt
or their ins their normal fees for svc. coverage is usually provided for diag test or cond caused by
disease, illness, or injury. Routine screening and well vts are not always covered, also known as
"fee-for-service".
Joint Commission - ANS Which organization evaluates the policies, procedures, and outcomes
of care provided by hospitals?
This organization has been responsible for accrediting healthcare organizations since the middle
1950s and determines whether the organization is continually monitoring and improving the
quality of care they provide.
Inpatient - ANS term used when a patient is admitted to the hospital w/ the expectation that
the pt will stay for a period of 24 hrs or more
Medical Record Number - ANS Unique number associated with your name in the medical
record
MRN
No Balance Billing Provision - ANS provider contract clause which states the provider agrees
to accept the amount the plan pays as payment in full not to bill the members/(except co-pays,
coinsurand deductables)
@COPYRIGHT 2026/2027 ALL RIGHTS RESERVED
1
, Correct Coding Initiative - ANS federal legislation that attempts to eliminate unbundling or
other inappropriate reporting of procedural codes for professional medical services rendered to
patients
CCI, Federal legislation that attempts to eliminate unbundling or other inappropriate reporting
of procedural codes for professional medical services rendered to patients
Medigap Insurance - ANS To pay for medical services and items that Medicare does not cover
and Medicare's coinsurance and deductibles, beneficiaries may purchase a supplemental
insurance. Private insurance designed to help pay for those amounts that are typically the
patient;s responsibility under Medicare.
Nurse Practicioner - ANS RN usually with a bacholer's degree who has successfully completed
additional training in a NP program at the masters or doctoral level
Non-Availability Statement - ANS certificate issued by a military treatment facility that cannot
provide needed care to TRICARE Standard beneficiaries. This means the beneficiary can seek
care from a civilian provider and reimbursement will be approved. NAS certificates are not
required for emergency care.
Managed Care - ANS Tries to balance the need for cost containment with access and quality
of service.
Master Patient Index - ANS Is permanent,aka Enterprise MPI or EMPI
MSP - ANS Medicare Secondary Payer
It is important for the insurance billing specialist to determine whether a patient's Medicare
coverage is primary or secondary
Liability Insurance - ANS protects the insured party from being held liable for other's financial
losses
covers the insured if injuries or damages are caused to other people or their property.
@COPYRIGHT 2026/2027 ALL RIGHTS RESERVED
2
