CHAM Arrival - Revenue Cycle Latest Update
2025-2026 Exam 85 Questions with 100% Verified
Correct Answers Guaranteed A+
*NAHAM sponsored resources: o NAHAM Collections Guide o Access Keys -
CORRECT ANSWER:
2 Midnight Rule- On July 1, 2015, CMS released proposed updates to the "Two-
Midnight" rule regarding when inpatient admissions are appropriate for payment under -
CORRECT ANSWER: Medicare Part A.
A valid Patient Consent to Release of Health Information must contain: - CORRECT
ANSWER: *Specific name or general designation of the program or person permitted to
make the disclosure •Name and title of the person or organization to which disclosure is
to be made • Name of the patient •Purpose of disclosure •What information is to be
disclosed •Signature of patient, if minor authorized signature from parent/guardian, if
patient is incompetent or deceased, the signature must be by a legal representative
such as Power of Attorney. •Date consent signed •A statement that the consent is
subject to revocation at any time. •Date the consent will expire • Once record
information is disclosed to an entity not covered by HIPAA, the information may be
subject to further use and disclosure without the protections offered by HIPAA
Affordable Care Act - CORRECT ANSWER: The Patient Protection and Affordable Care
Act (PPACA), commonly called the Affordable Care Act (ACA) or, Obamacare, is a
United States federal statute signed into law by President Barack Obama on March 23,
2010. It is the federal government's attempt to expand the number of people with
access to healthcare. Very comprehensive bill with 10 titles/chapters addressing various
areas regarding access to healthcare in the US.
Although some payers require paper UB04 claims, the majority of claims are submitted
electronically in a format called - CORRECT ANSWER: (837i).
Ambulatory Payment Classifications (APCs): is a system - CORRECT ANSWER: of
averaging and bundling using CPT procedure codes, HCPCS Level II, and revenue
codes submitted for payment. The APC system utilizes groups of CPT codes based on
, clinical and resource similarity and establishes payment rates for each APC grouping.
The 650 + APCs are divided by significant procedures, medical services, ancillary
services and partial hospitalization services. The APCs are similar clinically, by
resources used and cost. A payment rate has been established for each APC.
An interdisciplinary case management team (which may consist of utilization review and
discharge planning functions work directly with healthcare providers to ensure -
CORRECT ANSWER: all admissions and observation stays in the hospital are justified,
documentation supports the appropriate level of care and payment for the hospital,
roadblock from timely discharge form the facility removed and that condition of care
across the continuum improves quality, patient satisfaction avoiding unnecessary
readmissions.
Back Office- Patient Financial Services/Billing - CORRECT ANSWER: Now that the
patient has received services and charges are entered, the next stage in the revenue
cycle is the submission of the claim.
Basic principles of documentation which apply to all health care services and levels of
care: - CORRECT ANSWER: *Record should be complete, accurate and legible *The
documentation of each patient encounter should include the following: *Patient name,
age, other demographic information *Reason for the encounter, relevant history,
physical finding including health risks such as obesity, hypertension etc., all diagnostic
tests and results. *Assessment, clinical impression and diagnosis o Medical necessity
for tests, procedures, other care ordered *Patient's response to therapy/care provided;
good or bad *Changes in treatment plan and/or revision of diagnoses *Plan of care and
any risks associated with care plan. *Name of person documenting, and the date and
time of assessment
Case Management - CORRECT ANSWER: *Insurance group name [situational]
*Insurance group number [situational]*treatment authorization code [situational]
*document control number [situational] *employer name [situational] *diagnosis and
procedure code qualifier *principle diagnosis code *other diagnosis codes*admitting
diagnosis *patient's reason for visit [situational] *principal procedure code and date
[situational] *other procedure code and date [situational] *attending provider name and
identifiers (including NPI) [situational] *operating provider name and identifiers
[situational] *remarks [situational] *code-code field [situational
2025-2026 Exam 85 Questions with 100% Verified
Correct Answers Guaranteed A+
*NAHAM sponsored resources: o NAHAM Collections Guide o Access Keys -
CORRECT ANSWER:
2 Midnight Rule- On July 1, 2015, CMS released proposed updates to the "Two-
Midnight" rule regarding when inpatient admissions are appropriate for payment under -
CORRECT ANSWER: Medicare Part A.
A valid Patient Consent to Release of Health Information must contain: - CORRECT
ANSWER: *Specific name or general designation of the program or person permitted to
make the disclosure •Name and title of the person or organization to which disclosure is
to be made • Name of the patient •Purpose of disclosure •What information is to be
disclosed •Signature of patient, if minor authorized signature from parent/guardian, if
patient is incompetent or deceased, the signature must be by a legal representative
such as Power of Attorney. •Date consent signed •A statement that the consent is
subject to revocation at any time. •Date the consent will expire • Once record
information is disclosed to an entity not covered by HIPAA, the information may be
subject to further use and disclosure without the protections offered by HIPAA
Affordable Care Act - CORRECT ANSWER: The Patient Protection and Affordable Care
Act (PPACA), commonly called the Affordable Care Act (ACA) or, Obamacare, is a
United States federal statute signed into law by President Barack Obama on March 23,
2010. It is the federal government's attempt to expand the number of people with
access to healthcare. Very comprehensive bill with 10 titles/chapters addressing various
areas regarding access to healthcare in the US.
Although some payers require paper UB04 claims, the majority of claims are submitted
electronically in a format called - CORRECT ANSWER: (837i).
Ambulatory Payment Classifications (APCs): is a system - CORRECT ANSWER: of
averaging and bundling using CPT procedure codes, HCPCS Level II, and revenue
codes submitted for payment. The APC system utilizes groups of CPT codes based on
, clinical and resource similarity and establishes payment rates for each APC grouping.
The 650 + APCs are divided by significant procedures, medical services, ancillary
services and partial hospitalization services. The APCs are similar clinically, by
resources used and cost. A payment rate has been established for each APC.
An interdisciplinary case management team (which may consist of utilization review and
discharge planning functions work directly with healthcare providers to ensure -
CORRECT ANSWER: all admissions and observation stays in the hospital are justified,
documentation supports the appropriate level of care and payment for the hospital,
roadblock from timely discharge form the facility removed and that condition of care
across the continuum improves quality, patient satisfaction avoiding unnecessary
readmissions.
Back Office- Patient Financial Services/Billing - CORRECT ANSWER: Now that the
patient has received services and charges are entered, the next stage in the revenue
cycle is the submission of the claim.
Basic principles of documentation which apply to all health care services and levels of
care: - CORRECT ANSWER: *Record should be complete, accurate and legible *The
documentation of each patient encounter should include the following: *Patient name,
age, other demographic information *Reason for the encounter, relevant history,
physical finding including health risks such as obesity, hypertension etc., all diagnostic
tests and results. *Assessment, clinical impression and diagnosis o Medical necessity
for tests, procedures, other care ordered *Patient's response to therapy/care provided;
good or bad *Changes in treatment plan and/or revision of diagnoses *Plan of care and
any risks associated with care plan. *Name of person documenting, and the date and
time of assessment
Case Management - CORRECT ANSWER: *Insurance group name [situational]
*Insurance group number [situational]*treatment authorization code [situational]
*document control number [situational] *employer name [situational] *diagnosis and
procedure code qualifier *principle diagnosis code *other diagnosis codes*admitting
diagnosis *patient's reason for visit [situational] *principal procedure code and date
[situational] *other procedure code and date [situational] *attending provider name and
identifiers (including NPI) [situational] *operating provider name and identifiers
[situational] *remarks [situational] *code-code field [situational
