CHAM QUESTIONS 2026 FINAL REVIEW PACK
COMPLETE QUESTION SET AND CORE
CONCEPT SUMMARY
◉ Access. Answer: The patient's ability to obtain medical care. The
ease is determined by such components as the availability of medical
services and their acceptability to the patient, the location of health-
care facilities, transportation, hours of operation and cost of care.
◉ Account Number. Answer: A number assigned to each account.
This number is used to identify the account and all charges and
payments received.
◉ Acute Care. Answer: Medical attention given to patients with
conditions of sudden onset that demand urgent attention or care of
limited duration when the patient's health and wellness would
deteriorate without treatment. This care is generally short-term
rather than long-term or chronic care.
◉ Acute Impatient Care. Answer: A level of healthcare delivered to
patients experiencing acute illness or trauma. Generally short-term
(<30 days).
,◉ Add Ons. Answer: Patients who are scheduled for services less
than 24 hours in advance of the actual service time.
◉ Adjustor. Answer: Insurance company representative.
◉ Administrative Costs. Answer: Costs associated with creating and
submitting a bill for services, which could include: registration,
utilization review, coding, billing, and collection expenses.
◉ Admission Authorization. Answer: The process of third-party
payer notification of urgent/emergent inpatient admission within
specified time as determined by payers (usually 24-48 hours or next
business day).
◉ Admission Date. Answer: The first date the patient entered the
hospital for a specific visit.
◉ Admitting Diagnosis. Answer: Word, phrase, or International
Classification of Disease (ICD10) code used by the admitting
physician to identify a condition or disease from which a patient
suffers and for which the patient needs or seeks medical care.
◉ Admitting Physician. Answer: The physician who writes the order
for the patient to be admitted to the hospital. The physician must
,have admitting privileges at the facility providing the healthcare
services.
◉ Advance Beneficiary Notice. Answer: A notice that a care provider
should give a Medicare beneficiary to sign if the services being
provided may not be considered medically necessary and Medicare
may not pay for them. Allows the beneficiary to make an informed
decision prior to services regarding whether or not they wish to
receive services. Are not routinely given to emergency department
patients.
◉ Advance Directive. Answer: A written instruction relating to the
provision of healthcare when a patient is incapacitated. It could
include appointing someone to make medical decisions, a statement
expressing the patient's wishes about anatomical gifts (i.e. organ
donation) and general statements about whether or not life
sustaining treatments should be withheld or withdrawn.
◉ Adverse Selection. Answer: Among applicants for a given group or
individual program, the tendency for those with an impaired health
status, or who are prone to higher than average utilization of
benefits to be enrolled in disproportionate number and lower
deductibles.
◉ Alias. Answer: A name by which the patient is also "known as", or
formerly known as.
, ◉ All Patient Diagnosis Related Groups Assignment of Benefits
(APDRG). Answer: A prospective hospital claims reimbursement
system currently utilized by the federal government Medicaid
program and the states of New York and New Jersey. Designed to
describe the complete cross section of patients seen in acute care
hospitals. Approximately 639 are defined according to the principal
diagnosis, secondary diagnoses, procedures, age, birth weight, sex
and discharge status. Each category has an established fixed
reimbursement rate based on average cost of treatment within a
geographic area. Were developed to quantify the difference in
demographic groups and clinical risk factors for patients treated in
hospitals. This proprietary grouping system's (i.e. 3M) purpose is to
obtain fair and accurate statistical comparisons between disparate
populations and groups. Unlike the Diagnosis Related Group (DRG)
reimbursement system, which is intended to capture resource
utilization intensity, this system captures and relates the severity of
illness and risk of mortality factors present as a result of a patient's
disease and disorders and the interaction of those disorders. A form
is signed by the patient giving the healthcare provider authority to
bill his/her insurance plan and receive payment. The form is
generally presented and signed at the time of registration.
◉ Alphanumeric. Answer: Letters, numbers, punctuation marks and
mathematical symbols, as opposed to "numeric" which is numbers
only. Term typically related to the kind of data accepted in a
computer field or in coding.
COMPLETE QUESTION SET AND CORE
CONCEPT SUMMARY
◉ Access. Answer: The patient's ability to obtain medical care. The
ease is determined by such components as the availability of medical
services and their acceptability to the patient, the location of health-
care facilities, transportation, hours of operation and cost of care.
◉ Account Number. Answer: A number assigned to each account.
This number is used to identify the account and all charges and
payments received.
◉ Acute Care. Answer: Medical attention given to patients with
conditions of sudden onset that demand urgent attention or care of
limited duration when the patient's health and wellness would
deteriorate without treatment. This care is generally short-term
rather than long-term or chronic care.
◉ Acute Impatient Care. Answer: A level of healthcare delivered to
patients experiencing acute illness or trauma. Generally short-term
(<30 days).
,◉ Add Ons. Answer: Patients who are scheduled for services less
than 24 hours in advance of the actual service time.
◉ Adjustor. Answer: Insurance company representative.
◉ Administrative Costs. Answer: Costs associated with creating and
submitting a bill for services, which could include: registration,
utilization review, coding, billing, and collection expenses.
◉ Admission Authorization. Answer: The process of third-party
payer notification of urgent/emergent inpatient admission within
specified time as determined by payers (usually 24-48 hours or next
business day).
◉ Admission Date. Answer: The first date the patient entered the
hospital for a specific visit.
◉ Admitting Diagnosis. Answer: Word, phrase, or International
Classification of Disease (ICD10) code used by the admitting
physician to identify a condition or disease from which a patient
suffers and for which the patient needs or seeks medical care.
◉ Admitting Physician. Answer: The physician who writes the order
for the patient to be admitted to the hospital. The physician must
,have admitting privileges at the facility providing the healthcare
services.
◉ Advance Beneficiary Notice. Answer: A notice that a care provider
should give a Medicare beneficiary to sign if the services being
provided may not be considered medically necessary and Medicare
may not pay for them. Allows the beneficiary to make an informed
decision prior to services regarding whether or not they wish to
receive services. Are not routinely given to emergency department
patients.
◉ Advance Directive. Answer: A written instruction relating to the
provision of healthcare when a patient is incapacitated. It could
include appointing someone to make medical decisions, a statement
expressing the patient's wishes about anatomical gifts (i.e. organ
donation) and general statements about whether or not life
sustaining treatments should be withheld or withdrawn.
◉ Adverse Selection. Answer: Among applicants for a given group or
individual program, the tendency for those with an impaired health
status, or who are prone to higher than average utilization of
benefits to be enrolled in disproportionate number and lower
deductibles.
◉ Alias. Answer: A name by which the patient is also "known as", or
formerly known as.
, ◉ All Patient Diagnosis Related Groups Assignment of Benefits
(APDRG). Answer: A prospective hospital claims reimbursement
system currently utilized by the federal government Medicaid
program and the states of New York and New Jersey. Designed to
describe the complete cross section of patients seen in acute care
hospitals. Approximately 639 are defined according to the principal
diagnosis, secondary diagnoses, procedures, age, birth weight, sex
and discharge status. Each category has an established fixed
reimbursement rate based on average cost of treatment within a
geographic area. Were developed to quantify the difference in
demographic groups and clinical risk factors for patients treated in
hospitals. This proprietary grouping system's (i.e. 3M) purpose is to
obtain fair and accurate statistical comparisons between disparate
populations and groups. Unlike the Diagnosis Related Group (DRG)
reimbursement system, which is intended to capture resource
utilization intensity, this system captures and relates the severity of
illness and risk of mortality factors present as a result of a patient's
disease and disorders and the interaction of those disorders. A form
is signed by the patient giving the healthcare provider authority to
bill his/her insurance plan and receive payment. The form is
generally presented and signed at the time of registration.
◉ Alphanumeric. Answer: Letters, numbers, punctuation marks and
mathematical symbols, as opposed to "numeric" which is numbers
only. Term typically related to the kind of data accepted in a
computer field or in coding.
