CHAM MEDICARE REVIEW SHEET
2026 FULL QUESTIONS AND
ACCURATE ANSWERS
◉ A physician office submitting an invoice (claim) for payment when
the patient has health insurance is an example of a transaction between
__________ and _________________. Answer: Provider; third-party
payer
◉ Dr. Gilbert sees a 14 y/o male with adolescent idiopathic thoracic
scoliosis. Surgery for spinal fusion was cancelled after the patient was
diagnosed with mononucleosis. On today's visit the patient is started on
prednisone for severe sore throat and difficulty swallowing. The patient
was accompanied by his parents who have health insurance through the
mother's employment at the State Department of Treasury.
Who is the first party in this healthcare reimbursement scenario?
Answer: Parents
◉ Successful RCM programs use this type of approach, which promotes
collaboration among various clinical departments and emphasizes an
education strategy for all members. Answer: Multidisciplinary model
◉ Dr. Gilbert sees a 14 y/o male with adolescent idiopathic thoracic
scoliosis. Surgery for spinal fusion was cancelled after the patient was
diagnosed with mononucleosis. On today's visit the patient is started on
prednisone for severe sore throat and difficulty swallowing. The patient
, was accompanied by his parents who have health insurance through the
mother's employment at the State Department of Treasury.
Who is the second party in this healthcare reimbursement scenario?
Answer: Dr. Gilbert
◉ The US healthcare sector represents a significant portion of the US
economy. The trend of _______________ spending on healthcare has
been consistent for more than a decade. Answer: increased
◉ Dr. Gilbert sees a 14 y/o male with adolescent idiopathic thoracic
scoliosis. Surgery for spinal fusion was cancelled after the patient was
diagnosed with mononucleosis. On today's visit the patient is started on
prednisone for severe sore throat and difficulty swallowing. The patient
was accompanied by his parents who have health insurance through the
mother's employment at the State Department of Treasury.
Who is the third party in this healthcare reimbursement scenario?
Answer: insurance company
◉ In the US, what is health insurance? Answer: Reduction of a person's
or a group's exposure to risk for unknown healthcare costs by the
assumption of that risk by an entity.
◉ The goal of revenue integrity is the produce a claim that is: Answer:
Clean, complete, and compliant.
◉ Which of the following is NOT a component of the revenue cycle?
Answer: Revenue calculation
2026 FULL QUESTIONS AND
ACCURATE ANSWERS
◉ A physician office submitting an invoice (claim) for payment when
the patient has health insurance is an example of a transaction between
__________ and _________________. Answer: Provider; third-party
payer
◉ Dr. Gilbert sees a 14 y/o male with adolescent idiopathic thoracic
scoliosis. Surgery for spinal fusion was cancelled after the patient was
diagnosed with mononucleosis. On today's visit the patient is started on
prednisone for severe sore throat and difficulty swallowing. The patient
was accompanied by his parents who have health insurance through the
mother's employment at the State Department of Treasury.
Who is the first party in this healthcare reimbursement scenario?
Answer: Parents
◉ Successful RCM programs use this type of approach, which promotes
collaboration among various clinical departments and emphasizes an
education strategy for all members. Answer: Multidisciplinary model
◉ Dr. Gilbert sees a 14 y/o male with adolescent idiopathic thoracic
scoliosis. Surgery for spinal fusion was cancelled after the patient was
diagnosed with mononucleosis. On today's visit the patient is started on
prednisone for severe sore throat and difficulty swallowing. The patient
, was accompanied by his parents who have health insurance through the
mother's employment at the State Department of Treasury.
Who is the second party in this healthcare reimbursement scenario?
Answer: Dr. Gilbert
◉ The US healthcare sector represents a significant portion of the US
economy. The trend of _______________ spending on healthcare has
been consistent for more than a decade. Answer: increased
◉ Dr. Gilbert sees a 14 y/o male with adolescent idiopathic thoracic
scoliosis. Surgery for spinal fusion was cancelled after the patient was
diagnosed with mononucleosis. On today's visit the patient is started on
prednisone for severe sore throat and difficulty swallowing. The patient
was accompanied by his parents who have health insurance through the
mother's employment at the State Department of Treasury.
Who is the third party in this healthcare reimbursement scenario?
Answer: insurance company
◉ In the US, what is health insurance? Answer: Reduction of a person's
or a group's exposure to risk for unknown healthcare costs by the
assumption of that risk by an entity.
◉ The goal of revenue integrity is the produce a claim that is: Answer:
Clean, complete, and compliant.
◉ Which of the following is NOT a component of the revenue cycle?
Answer: Revenue calculation
