1
CHAM EXAM QUESTIONS AND
CORRECT SOLUTIONS | UPDATED
2026
Accepting Assignment - correct-answer -When a provider agrees to accept the
allowable charges as the full fee and cannot charge the patient the difference
between the insurance payment and the provider's normal fee.
Access - correct-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 - correct-answer -A number assigned to each account. This
number is used to identify the account and all charges and payments received.
Acute Care - correct-answer -Medical attention given to patients with conditions
of sudden onset that demand urgent attention or care of limited duration when
, 2
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 - correct-answer -A level of healthcare delivered to patients
experiencing acute illness or trauma. Generally short-term (<30 days).
Add Ons - correct-answer -Patients who are scheduled for services less than 24
hours in advance of the actual service time.
Adjustor - correct-answer -Insurance company representative.
Administrative Costs - correct-answer -Costs associated with creating and
submitting a bill for services, which could include: registration, utilization review,
coding, billing, and collection expenses.
Admission Authorization - correct-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).
, 3
Admission Date - correct-answer -The first date the patient entered the hospital
for a specific visit.
Admitting Diagnosis - correct-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 - correct-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 - correct-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 - correct-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.
, 4
Adverse Selection - correct-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 - correct-answer -A name by which the patient is also "known as", or
formerly known as.
All Patient Diagnosis Related Groups Assignment of Benefits (APDRG) - correct-
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.
CHAM EXAM QUESTIONS AND
CORRECT SOLUTIONS | UPDATED
2026
Accepting Assignment - correct-answer -When a provider agrees to accept the
allowable charges as the full fee and cannot charge the patient the difference
between the insurance payment and the provider's normal fee.
Access - correct-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 - correct-answer -A number assigned to each account. This
number is used to identify the account and all charges and payments received.
Acute Care - correct-answer -Medical attention given to patients with conditions
of sudden onset that demand urgent attention or care of limited duration when
, 2
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 - correct-answer -A level of healthcare delivered to patients
experiencing acute illness or trauma. Generally short-term (<30 days).
Add Ons - correct-answer -Patients who are scheduled for services less than 24
hours in advance of the actual service time.
Adjustor - correct-answer -Insurance company representative.
Administrative Costs - correct-answer -Costs associated with creating and
submitting a bill for services, which could include: registration, utilization review,
coding, billing, and collection expenses.
Admission Authorization - correct-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).
, 3
Admission Date - correct-answer -The first date the patient entered the hospital
for a specific visit.
Admitting Diagnosis - correct-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 - correct-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 - correct-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 - correct-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.
, 4
Adverse Selection - correct-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 - correct-answer -A name by which the patient is also "known as", or
formerly known as.
All Patient Diagnosis Related Groups Assignment of Benefits (APDRG) - correct-
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.
