AAHAM CRCS EVALUATION EXAMS 2025/2026 QUESTIONS
WITH ANSWERS RATED A+
✔✔hospice care - ✔✔coordinated, palliative care provided to terminally ill
patients and their families by nonprofit organizations.
✔✔HRSA - ✔✔Health Resources and Services Administration; one of the DHHS
Operating Divisions.
✔✔HSA - ✔✔Health Savings Account (formerly known as Medical Savings
Account, or MSA).
✔✔I-Bill - ✔✔an itemized statement.
✔✔ICD - ✔✔International Classification of Diseases; a standard transaction set used for
1) chief complaint or diagnosis for professional services and inpatient procedures, and
2) for diagnosis and procedure codes for professional and technical services for both
inpatient and outpatient procedures.
✔✔ICD-10 - ✔✔the newest version of the International Classification of Diseases.
✔✔IEQ - ✔✔Initial Enrollment Questionnaire; a questionnaire mailed about three
months before patients become entitled to Medicare; it asks about any other healthcare
coverage that may be primary to Medicare.
✔✔IHS - ✔✔Indian Health Service; one of the DHHS Operating Divisions.
✔✔implied consent - by law - ✔✔consent that occurs in a situation where the patient is
unconscious and is taken to the emergency room; the law
allows treating the patient.
✔✔implied consent - in fact - ✔✔consent by silence; the patient implies consent
to the treatment by not objecting.
✔✔imprest - ✔✔petty cash.
✔✔indigent - ✔✔an individual with no means of paying for services or
treatments, who is not eligible for Medicaid or another public assistance program.
✔✔informed consent - ✔✔consent given when the risks and benefits of a
treatment are understood and the patient makes an informed decision whether to
receive that treatment.
,✔✔Initial Enrollment Questionnaire (IEQ) - ✔✔a questionnaire mailed about three
months before patients become entitled to Medicare; it asks about any other healthcare
coverage that may be primary to Medicare.
✔✔IEQ - ✔✔Initial Enrollment Questionnaire
✔✔initial preventive physical examination (IPPE) - ✔✔the "Welcome to Medicare
Physical Exam" that is offered to each beneficiary once in a lifetime.
✔✔IPPE - ✔✔initial preventive physical examination
✔✔initiation - ✔✔the beginning of the treatment for a new encounter or a new
plan of care; one of the times when a triggering event for an ABN can occur.
✔✔intentional - ✔✔a type of skip in which someone avoids paying bills by
changing his or her residency and failing to leave a forwarding address, purposely
changing his or her name, or intentionally giving false information.
✔✔involuntary bankruptcy - ✔✔a type of bankruptcy in which a debtor can be placed
under Chapter 7 or 11 if the debtor has 12 or more creditors, three of which have claims
in excess of $5,000 each and are willing to force the issue, or one creditor owed at least
$10,775.
✔✔IPPS - ✔✔Inpatient Prospective Payment System
✔✔Joint Commission, The (TJC) - ✔✔the organization that accredits hospitals;
formerly called the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO); accreditation is extremely important for hospitals as it is a requirement of
participation in the Medicare program.
✔✔judgment - ✔✔a legally verified claim against a debtor; a legal right to collect
a debt that can be used to obtain a lien.
✔✔Kennedy-Kassenbaum Bill - ✔✔another name for the Health Insurance Portability
and Accountability Act of 1996 (HIPAA); it created federal standards for insurers,
HMOs, and employer plans including those who are self-insured.
✔✔Local Coverage Determination (LCD) - ✔✔policies developed by Medicare area
contractors that specify criteria for services and show under what clinical circumstances
an item or service is considered to be reasonable, necessary, and appropriate.
✔✔lien - ✔✔a recorded claim against real or personal property; if the property is sold,
the creditor must be paid out of the proceeds of that sale.
, ✔✔living will - ✔✔a document that specifies what treatments a patient does and
does not wish to receive; it means that difficult decisions about future care are made
while the person is alert; patients can choose the circumstances under which they will
die; and patients' desires regarding organ donation are made known.
✔✔long term care - ✔✔care generally provided to the chronically ill or disabled
in a nursing facility or rest home; among the services provided by
nursing facilities are 24-hour nursing care; rehabilitative services such as physical,
occupational, and speech therapy; and assistance with daily activities like eating,
bathing, and dressing.
✔✔LTR - ✔✔lifetime reserve.
✔✔MAAC - ✔✔maximum allowable actual charge.
✔✔MCE - ✔✔Medicare Code Editor; software that edits claims to detect incorrect billing
data that is being submitted.
✔✔MDC - ✔✔major diagnostic category; one of 25 groups of DRGs (diagnosisrelated
groups).
✔✔MDS - ✔✔Minimum Data Set; part of the federally required process for
clinical assessment of all residents in Medicare- or Medicaid-certified nursing homes;
the MDS then determines the Resource Utilization Group (RUG) and hence the
payment.
✔✔Medicaid - ✔✔a health insurance program for certain low-income people; it is
funded and administered through a state-federal partnership.
✔✔Medicare - ✔✔a health insurance program for the elderly (age 65 or older)
and those under age 65 who have permanent disabilities or end stage renal disease
(ESRD).
✔✔Medicare Advantage Plans - ✔✔another name for Medicare Part C; managed
care coverage provided by private insurance companies approved by Medicare.
✔✔Medicare Code Editor (MCE) - ✔✔software that edits claims to detect incorrect
billing data that is being submitted.
✔✔Medicare Participating Physician Program - ✔✔a program that enables providers to
accept assignment of benefits.
WITH ANSWERS RATED A+
✔✔hospice care - ✔✔coordinated, palliative care provided to terminally ill
patients and their families by nonprofit organizations.
✔✔HRSA - ✔✔Health Resources and Services Administration; one of the DHHS
Operating Divisions.
✔✔HSA - ✔✔Health Savings Account (formerly known as Medical Savings
Account, or MSA).
✔✔I-Bill - ✔✔an itemized statement.
✔✔ICD - ✔✔International Classification of Diseases; a standard transaction set used for
1) chief complaint or diagnosis for professional services and inpatient procedures, and
2) for diagnosis and procedure codes for professional and technical services for both
inpatient and outpatient procedures.
✔✔ICD-10 - ✔✔the newest version of the International Classification of Diseases.
✔✔IEQ - ✔✔Initial Enrollment Questionnaire; a questionnaire mailed about three
months before patients become entitled to Medicare; it asks about any other healthcare
coverage that may be primary to Medicare.
✔✔IHS - ✔✔Indian Health Service; one of the DHHS Operating Divisions.
✔✔implied consent - by law - ✔✔consent that occurs in a situation where the patient is
unconscious and is taken to the emergency room; the law
allows treating the patient.
✔✔implied consent - in fact - ✔✔consent by silence; the patient implies consent
to the treatment by not objecting.
✔✔imprest - ✔✔petty cash.
✔✔indigent - ✔✔an individual with no means of paying for services or
treatments, who is not eligible for Medicaid or another public assistance program.
✔✔informed consent - ✔✔consent given when the risks and benefits of a
treatment are understood and the patient makes an informed decision whether to
receive that treatment.
,✔✔Initial Enrollment Questionnaire (IEQ) - ✔✔a questionnaire mailed about three
months before patients become entitled to Medicare; it asks about any other healthcare
coverage that may be primary to Medicare.
✔✔IEQ - ✔✔Initial Enrollment Questionnaire
✔✔initial preventive physical examination (IPPE) - ✔✔the "Welcome to Medicare
Physical Exam" that is offered to each beneficiary once in a lifetime.
✔✔IPPE - ✔✔initial preventive physical examination
✔✔initiation - ✔✔the beginning of the treatment for a new encounter or a new
plan of care; one of the times when a triggering event for an ABN can occur.
✔✔intentional - ✔✔a type of skip in which someone avoids paying bills by
changing his or her residency and failing to leave a forwarding address, purposely
changing his or her name, or intentionally giving false information.
✔✔involuntary bankruptcy - ✔✔a type of bankruptcy in which a debtor can be placed
under Chapter 7 or 11 if the debtor has 12 or more creditors, three of which have claims
in excess of $5,000 each and are willing to force the issue, or one creditor owed at least
$10,775.
✔✔IPPS - ✔✔Inpatient Prospective Payment System
✔✔Joint Commission, The (TJC) - ✔✔the organization that accredits hospitals;
formerly called the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO); accreditation is extremely important for hospitals as it is a requirement of
participation in the Medicare program.
✔✔judgment - ✔✔a legally verified claim against a debtor; a legal right to collect
a debt that can be used to obtain a lien.
✔✔Kennedy-Kassenbaum Bill - ✔✔another name for the Health Insurance Portability
and Accountability Act of 1996 (HIPAA); it created federal standards for insurers,
HMOs, and employer plans including those who are self-insured.
✔✔Local Coverage Determination (LCD) - ✔✔policies developed by Medicare area
contractors that specify criteria for services and show under what clinical circumstances
an item or service is considered to be reasonable, necessary, and appropriate.
✔✔lien - ✔✔a recorded claim against real or personal property; if the property is sold,
the creditor must be paid out of the proceeds of that sale.
, ✔✔living will - ✔✔a document that specifies what treatments a patient does and
does not wish to receive; it means that difficult decisions about future care are made
while the person is alert; patients can choose the circumstances under which they will
die; and patients' desires regarding organ donation are made known.
✔✔long term care - ✔✔care generally provided to the chronically ill or disabled
in a nursing facility or rest home; among the services provided by
nursing facilities are 24-hour nursing care; rehabilitative services such as physical,
occupational, and speech therapy; and assistance with daily activities like eating,
bathing, and dressing.
✔✔LTR - ✔✔lifetime reserve.
✔✔MAAC - ✔✔maximum allowable actual charge.
✔✔MCE - ✔✔Medicare Code Editor; software that edits claims to detect incorrect billing
data that is being submitted.
✔✔MDC - ✔✔major diagnostic category; one of 25 groups of DRGs (diagnosisrelated
groups).
✔✔MDS - ✔✔Minimum Data Set; part of the federally required process for
clinical assessment of all residents in Medicare- or Medicaid-certified nursing homes;
the MDS then determines the Resource Utilization Group (RUG) and hence the
payment.
✔✔Medicaid - ✔✔a health insurance program for certain low-income people; it is
funded and administered through a state-federal partnership.
✔✔Medicare - ✔✔a health insurance program for the elderly (age 65 or older)
and those under age 65 who have permanent disabilities or end stage renal disease
(ESRD).
✔✔Medicare Advantage Plans - ✔✔another name for Medicare Part C; managed
care coverage provided by private insurance companies approved by Medicare.
✔✔Medicare Code Editor (MCE) - ✔✔software that edits claims to detect incorrect
billing data that is being submitted.
✔✔Medicare Participating Physician Program - ✔✔a program that enables providers to
accept assignment of benefits.
