AAHAM CRCS FINAL PAPER 2025/2026 QUESTIONS WITH
ANSWERS RATED A+
✔✔DOJ - ✔✔Department of Justice; one of the entities, along with the Office of
Inspector General (OIG), that coordinates fraud and abuse control.
✔✔DSMT - ✔✔Diabetes Self-Management Training.
✔✔dual eligible - ✔✔an individual who is entitled to Medicare Part A and/or
Part B, and also eligible for some form of Medicaid benefit.
✔✔Durable Power of Attorney for Healthcare - ✔✔also known as Healthcare
Power of Attorney; a document that designates someone else (known as
a healthcare surrogate, agent, or proxy) to make decisions on the
patient's behalf if he or she is unable to do so.
✔✔ECOA - ✔✔Equal Credit Opportunity Act
✔✔Equal Credit Opportunity Act - ✔✔a law that prohibits credit discrimination on the
basis of race, color, religion, national origin, sex, marital status, age, or because
someone receives public assistance.
✔✔E&M - ✔✔evaluation and management; both the process of and the charge for
examining a patient and formulating a treatment plan.
✔✔EGHP - ✔✔Employer Group Health Plan.
✔✔emancipation - ✔✔a process by which a minor is freed from parental control
based on specific criteria (the minor no longer requires parental
guidance or financial support, fathered or gave birth to a child, or has reached the age
of majority).
✔✔Emergency Medical Treatment and Active Labor Act - ✔✔also known as the Federal
Anti-Dumping Statute; legislation enacted in 1986 in response to concerns that hospitals
were refusing to treat patients without insurance and even transferring them to other
facilities and leaving them there,
sometimes without notifying the receiving facility.
✔✔EMTALA - ✔✔Emergency Medical Treatment and Active Labor Act
✔✔EOB - ✔✔Explanation of Benefits; the former name for the Medicare
Summary Notice, which is a remittance advice.
,✔✔evaluation and management (E&M) - ✔✔both the process of and the charge for
examining a patient and formulating a treatment plan.
✔✔Fair Credit Billing Act - ✔✔an amendment to the Truth in Lending Act; it protects
consumers from inaccurate or unfair practices by issuers of
open-ended credit, requires creditors to inform debtors of their rights and of the
responsibilities of the creditor, and has as its principle thrust to provide for prompt
settlement of billing disputes.
✔✔Fair Credit Reporting Act - ✔✔defines what information from "consumer reports" can
be used, by whom, and when; it provides the maximum protection of a consumer's right
to privacy and confidentiality of credit
reports.
✔✔Fair Debt Collection Practices Act - ✔✔legislation enacted as the result of evidence
that debt collectors were using abusive, deceptive, and unfair collection practices; it
imposes strict limitations and prohibitions on debt collection practices.
✔✔false - ✔✔a type of skip generally caused by clerical error at the time of
registration, such as transposed numbers in the street address, an incorrect zip code, or
incomplete information.
✔✔False Claims Act - ✔✔legislation that prohibits making a false record or
statement to get a false/fraudulent claim paid by the government,
submission of false/fraudulent claims, and conspiring to have
false/fraudulent claims paid by the government.
✔✔FDA - ✔✔Food and Drug Administration; one of the DHHS Operating
Divisions.
✔✔FDCPA - ✔✔Fair Debt Collection Practices Act; legislation enacted as the
result of evidence that debt collectors were using abusive, deceptive, and unfair
collection practices; it imposes strict limitations and prohibitions on debt collection
practices.
✔✔Federal Anti-Dumping Statute - ✔✔another name for the Emergency Medical
Treatment and Active Labor Act (EMTALA); legislation enacted in 1986 in response to
concerns that hospitals were refusing to treat patients without insurance and even
transferring them to other facilities and leaving them there, sometimes without notifying
the receiving facility.
✔✔FOIA - ✔✔Freedom of Information Act.
✔✔fraud - ✔✔the intentional or illegal deception or misrepresentation made for
, the purpose of personal gain, or to harm or manipulate another person or organization;
fraud includes incorrect reporting of diagnosis and procedure codes to maximize
payments, billing for services not furnished, altering claims to receive payment,
accepting kickbacks, the routine waiver of deductible and coinsurance amounts, etc.
✔✔GAAP - ✔✔generally accepted accounting principles.
✔✔HCFA - ✔✔Health Care Financing Administration; the former name for the
Centers for Medicare and Medicaid Services.
✔✔HCPCS - ✔✔Healthcare Common Procedure Coding System; the federal
government equivalent to the CPT system.
✔✔Health Care Fraud Prevention and Enforcement Action Team - ✔✔HEAT, a team
that uses government resources to help prevent fraud, waste, and abuse in both the
Medicare and Medicaid programs.
✔✔Healthcare Power of Attorney - ✔✔also known as Durable Power of Attorney for
Healthcare; a document that designates someone else (known as a healthcare
surrogate, agent, or proxy) to make decisions on the patient's
behalf if he or she is unable to do so.
✔✔HICN - ✔✔Medicare Health Insurance Claim Number
✔✔Hill-Burton Act - ✔✔the Hospital Survey and Construction Act; legislation
designed to assist hospitals by providing loans for construction projects; once the
hospitals were operational, the funds that were borrowed were to be paid back in the
form of charity; also known as Title I.
✔✔HIPAA - ✔✔Health Insurance Portability and Accountability Act of 1996
✔✔HIPAA is also know as? - ✔✔the Kennedy-Kassenbaum Bill
✔✔Health Insurance Portability and Accountability Act of 1996 - ✔✔also known as the
Kennedy-Kassenbaum Bill; it created federal standards for insurers, HMOs, and
employer plans including those who are selfinsured.
✔✔HMO - ✔✔Health Maintenance Organization; one of five types of Medicare
Advantage Plans in which members must generally get healthcare from providers in the
plan's network.
✔✔home health care - ✔✔preventative, supportive, rehabilitative, or therapeutic
care provided to a patient at home; to be reimbursed by the Medicare program, a
physician must certify that the patient is home bound, in need of skilled nursing care on
ANSWERS RATED A+
✔✔DOJ - ✔✔Department of Justice; one of the entities, along with the Office of
Inspector General (OIG), that coordinates fraud and abuse control.
✔✔DSMT - ✔✔Diabetes Self-Management Training.
✔✔dual eligible - ✔✔an individual who is entitled to Medicare Part A and/or
Part B, and also eligible for some form of Medicaid benefit.
✔✔Durable Power of Attorney for Healthcare - ✔✔also known as Healthcare
Power of Attorney; a document that designates someone else (known as
a healthcare surrogate, agent, or proxy) to make decisions on the
patient's behalf if he or she is unable to do so.
✔✔ECOA - ✔✔Equal Credit Opportunity Act
✔✔Equal Credit Opportunity Act - ✔✔a law that prohibits credit discrimination on the
basis of race, color, religion, national origin, sex, marital status, age, or because
someone receives public assistance.
✔✔E&M - ✔✔evaluation and management; both the process of and the charge for
examining a patient and formulating a treatment plan.
✔✔EGHP - ✔✔Employer Group Health Plan.
✔✔emancipation - ✔✔a process by which a minor is freed from parental control
based on specific criteria (the minor no longer requires parental
guidance or financial support, fathered or gave birth to a child, or has reached the age
of majority).
✔✔Emergency Medical Treatment and Active Labor Act - ✔✔also known as the Federal
Anti-Dumping Statute; legislation enacted in 1986 in response to concerns that hospitals
were refusing to treat patients without insurance and even transferring them to other
facilities and leaving them there,
sometimes without notifying the receiving facility.
✔✔EMTALA - ✔✔Emergency Medical Treatment and Active Labor Act
✔✔EOB - ✔✔Explanation of Benefits; the former name for the Medicare
Summary Notice, which is a remittance advice.
,✔✔evaluation and management (E&M) - ✔✔both the process of and the charge for
examining a patient and formulating a treatment plan.
✔✔Fair Credit Billing Act - ✔✔an amendment to the Truth in Lending Act; it protects
consumers from inaccurate or unfair practices by issuers of
open-ended credit, requires creditors to inform debtors of their rights and of the
responsibilities of the creditor, and has as its principle thrust to provide for prompt
settlement of billing disputes.
✔✔Fair Credit Reporting Act - ✔✔defines what information from "consumer reports" can
be used, by whom, and when; it provides the maximum protection of a consumer's right
to privacy and confidentiality of credit
reports.
✔✔Fair Debt Collection Practices Act - ✔✔legislation enacted as the result of evidence
that debt collectors were using abusive, deceptive, and unfair collection practices; it
imposes strict limitations and prohibitions on debt collection practices.
✔✔false - ✔✔a type of skip generally caused by clerical error at the time of
registration, such as transposed numbers in the street address, an incorrect zip code, or
incomplete information.
✔✔False Claims Act - ✔✔legislation that prohibits making a false record or
statement to get a false/fraudulent claim paid by the government,
submission of false/fraudulent claims, and conspiring to have
false/fraudulent claims paid by the government.
✔✔FDA - ✔✔Food and Drug Administration; one of the DHHS Operating
Divisions.
✔✔FDCPA - ✔✔Fair Debt Collection Practices Act; legislation enacted as the
result of evidence that debt collectors were using abusive, deceptive, and unfair
collection practices; it imposes strict limitations and prohibitions on debt collection
practices.
✔✔Federal Anti-Dumping Statute - ✔✔another name for the Emergency Medical
Treatment and Active Labor Act (EMTALA); legislation enacted in 1986 in response to
concerns that hospitals were refusing to treat patients without insurance and even
transferring them to other facilities and leaving them there, sometimes without notifying
the receiving facility.
✔✔FOIA - ✔✔Freedom of Information Act.
✔✔fraud - ✔✔the intentional or illegal deception or misrepresentation made for
, the purpose of personal gain, or to harm or manipulate another person or organization;
fraud includes incorrect reporting of diagnosis and procedure codes to maximize
payments, billing for services not furnished, altering claims to receive payment,
accepting kickbacks, the routine waiver of deductible and coinsurance amounts, etc.
✔✔GAAP - ✔✔generally accepted accounting principles.
✔✔HCFA - ✔✔Health Care Financing Administration; the former name for the
Centers for Medicare and Medicaid Services.
✔✔HCPCS - ✔✔Healthcare Common Procedure Coding System; the federal
government equivalent to the CPT system.
✔✔Health Care Fraud Prevention and Enforcement Action Team - ✔✔HEAT, a team
that uses government resources to help prevent fraud, waste, and abuse in both the
Medicare and Medicaid programs.
✔✔Healthcare Power of Attorney - ✔✔also known as Durable Power of Attorney for
Healthcare; a document that designates someone else (known as a healthcare
surrogate, agent, or proxy) to make decisions on the patient's
behalf if he or she is unable to do so.
✔✔HICN - ✔✔Medicare Health Insurance Claim Number
✔✔Hill-Burton Act - ✔✔the Hospital Survey and Construction Act; legislation
designed to assist hospitals by providing loans for construction projects; once the
hospitals were operational, the funds that were borrowed were to be paid back in the
form of charity; also known as Title I.
✔✔HIPAA - ✔✔Health Insurance Portability and Accountability Act of 1996
✔✔HIPAA is also know as? - ✔✔the Kennedy-Kassenbaum Bill
✔✔Health Insurance Portability and Accountability Act of 1996 - ✔✔also known as the
Kennedy-Kassenbaum Bill; it created federal standards for insurers, HMOs, and
employer plans including those who are selfinsured.
✔✔HMO - ✔✔Health Maintenance Organization; one of five types of Medicare
Advantage Plans in which members must generally get healthcare from providers in the
plan's network.
✔✔home health care - ✔✔preventative, supportive, rehabilitative, or therapeutic
care provided to a patient at home; to be reimbursed by the Medicare program, a
physician must certify that the patient is home bound, in need of skilled nursing care on
