1|Page
CHAM ARRIVAL REVENUE CYCLE NEWEST
2025 ACTUAL EXAM COMPLETE 100
QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |100%
GUARANTEED PASS!
Notice Law- Passed in March of 2015 requires hospitals
to provide observation patients who have a outpatient
observation stay of more than 24 hours an adequate oral
and written notification within - ANSWER-36 hours after
being placed in observation.
Hospital's will be required to: Explain the individual's
status as an outpatient and not as an i - ANSWER-npatient
and the reasons why; *Explain the implications of that
status on services furnished, in particular the implications
for cost-sharing requirements and subsequent coverage
eligibility for services furnished by a skilled nursing
facility; o is written and formatted using plain language
and made available in appropriate languages; o is signed
by the individual or a person acting on the individual's
,2|Page
behalf (representative) to acknowledge receipt of the
notification, or if the individual or representative refuses
to sign, the written notification is signed by the hospital
staff who presented it.
Utilization review (UR) monitors the use of - ANSWER-
resources, reviews stays and is a safeguard against
unnecessary and inappropriate medical care
The UR nurse will manage and monitor the case through-
out the course of the stay ensuring all needed services are
provided in a - ANSWER-timely manner. They may
arrange education for the patient and family.
UR assists with review of - ANSWER-medical necessity,
quality of care, appropriateness of decision making, place
of service, and length of hospital stay.
Types of Utilization Review - ANSWER-*Prospective - A
review of the patients proposed care plan, prior to
provision or service or entry into the facility. Used to
,3|Page
determine if medical necessity requirements will be met.
*Concurrent- a review of the patient's plan of care and
resource needs real time while patient is an
Discharge planning begins as soon as the patient is -
ANSWER-admitted into a facility, the discharge planner
is working with Case Management, UR and care
providers to manage the entire patient stay and move the
patient out of acute care as soon as medically possible.
The discharge planner considers: - ANSWER-*Estimate
the LOS based on assigned DRG. *Will there be any
delays with discharge? *What needs to be facilitated in
order to discharge the patient, will they need post-acute
care such as SNF, Home Care or Hospice services?
In collaboration with Case Management, an effective
Utilization Review program can help healthcare
organizations: - ANSWER-*Position the organization for
changes under healthcare reform with coordination of
care across the healthcare continuum *Enhance quality of
, 4|Page
care with interdisciplinary team focus on the progression
of the plan of care *Increase payment and decrease costs
by expediting patient discharge *Improve the revenue
cycle process by ensuring accurate coding for prompt
billing, reducing denials, and improving contracting terms
with managed care payers. *Proactively prepare for
Recovery Audit Contractor (RAC) audits and protect
against take backs.
Medical Documentation is required to record pertinent
facts, findings and observations about a person's -
ANSWER-individual health history, including; past and
present illnesses, examinations, tests, surgeries, other
treatments and outcomes. The record chronologically
documents the care the person has received.
Due to meaningful use requirements a vast majority of
hospitals have transitioned to - ANSWER-electronic
health records (EHR) and all federal and state
requirements still apply.
CHAM ARRIVAL REVENUE CYCLE NEWEST
2025 ACTUAL EXAM COMPLETE 100
QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |100%
GUARANTEED PASS!
Notice Law- Passed in March of 2015 requires hospitals
to provide observation patients who have a outpatient
observation stay of more than 24 hours an adequate oral
and written notification within - ANSWER-36 hours after
being placed in observation.
Hospital's will be required to: Explain the individual's
status as an outpatient and not as an i - ANSWER-npatient
and the reasons why; *Explain the implications of that
status on services furnished, in particular the implications
for cost-sharing requirements and subsequent coverage
eligibility for services furnished by a skilled nursing
facility; o is written and formatted using plain language
and made available in appropriate languages; o is signed
by the individual or a person acting on the individual's
,2|Page
behalf (representative) to acknowledge receipt of the
notification, or if the individual or representative refuses
to sign, the written notification is signed by the hospital
staff who presented it.
Utilization review (UR) monitors the use of - ANSWER-
resources, reviews stays and is a safeguard against
unnecessary and inappropriate medical care
The UR nurse will manage and monitor the case through-
out the course of the stay ensuring all needed services are
provided in a - ANSWER-timely manner. They may
arrange education for the patient and family.
UR assists with review of - ANSWER-medical necessity,
quality of care, appropriateness of decision making, place
of service, and length of hospital stay.
Types of Utilization Review - ANSWER-*Prospective - A
review of the patients proposed care plan, prior to
provision or service or entry into the facility. Used to
,3|Page
determine if medical necessity requirements will be met.
*Concurrent- a review of the patient's plan of care and
resource needs real time while patient is an
Discharge planning begins as soon as the patient is -
ANSWER-admitted into a facility, the discharge planner
is working with Case Management, UR and care
providers to manage the entire patient stay and move the
patient out of acute care as soon as medically possible.
The discharge planner considers: - ANSWER-*Estimate
the LOS based on assigned DRG. *Will there be any
delays with discharge? *What needs to be facilitated in
order to discharge the patient, will they need post-acute
care such as SNF, Home Care or Hospice services?
In collaboration with Case Management, an effective
Utilization Review program can help healthcare
organizations: - ANSWER-*Position the organization for
changes under healthcare reform with coordination of
care across the healthcare continuum *Enhance quality of
, 4|Page
care with interdisciplinary team focus on the progression
of the plan of care *Increase payment and decrease costs
by expediting patient discharge *Improve the revenue
cycle process by ensuring accurate coding for prompt
billing, reducing denials, and improving contracting terms
with managed care payers. *Proactively prepare for
Recovery Audit Contractor (RAC) audits and protect
against take backs.
Medical Documentation is required to record pertinent
facts, findings and observations about a person's -
ANSWER-individual health history, including; past and
present illnesses, examinations, tests, surgeries, other
treatments and outcomes. The record chronologically
documents the care the person has received.
Due to meaningful use requirements a vast majority of
hospitals have transitioned to - ANSWER-electronic
health records (EHR) and all federal and state
requirements still apply.
