AAHAM CRCS-P Study Questions With
Correct Answers
CRCS |- |CORRECT |ANSWER✔✔-Certified |Revenue |Cycle |Specialist
AAHAM |- |CORRECT |ANSWER✔✔-The |American |Association |of |Healthcare |Administrative |
Management
1-Day |Rule |- |CORRECT |ANSWER✔✔-a |requirement |that |all |diagnostic |or |outpatient |services
furnished |in |connection |with |the |principle |admitting |diagnosis |within |one |day |prior |to |the |
hospital |admission |are |bundled |with |the |inpatient |services |for |Medicare |billing.
3-Day |Rule |- |CORRECT |ANSWER✔✔-a |requirement |that |all |diagnostic |or |outpatient |services
furnished |in |connection |with |the |principle |admitting |diagnosis |within |three |days |prior |to |the |
hospital |admission |are |bundled |with |the |inpatient |services |for |Medicare |billing.
5010A1 |- |CORRECT |ANSWER✔✔-the |American |National |Standards |Institute |transaction |for |a
professional |claim |(the |electronic |equivalent |of |the |CMS |15000),
formerly |the |837P
837I |- |CORRECT |ANSWER✔✔-the |American |National |Standards |Institute |transaction |for |an
institutional |claim; |as |a |result |of |HIPAA, |it |is |replacing |the |electronic
UB-04.
837P |- |CORRECT |ANSWER✔✔-a |former |American |National |Standards |Institute |transaction |for |
a
,professional |claim |(the |electronic |equivalent |of |the |CMS |15000), |sincereplaced |by |the |5010A1.
ABN |- |CORRECT |ANSWER✔✔-the |Advance |Beneficiary |Notice |of |Noncoverage; |a |form |given |to
|a |Medicare |beneficiary |before |services |are |furnished |when |a |service |does |not |meet |or |is |not |
expected |to |meet |medical |necessity.
abuse |- |CORRECT |ANSWER✔✔-the |misuse |of |a |person, |substance, |service, |or |financial |matter |
such |that |harm |is |caused; |some |forms |of |healthcare |abuse |include |excessive |or |unwarranted |
use |of |technology, |pharmaceuticals, |and |services; |abuse |of |authority; |and |abuse |of |privacy, |
confidentiality, |or |duty |to |care; |it |also |includes |improper |billing |practices |(like |billing |Medicare |
instead |of |primary |insurer), |increasing |charges |to |Medicare |beneficiaries |but |not |to |other |
patients, |unbundling |of |services, |and |unnecessary |transfers |of
patients.
Accounts |Receivable |(AR) |Days |Outstanding |- |CORRECT |ANSWER✔✔-an |estimate, |using |
average |current |revenues, |of |the |days |required |to |turn |over |the |accounts |receivable |under |
normal |operating |conditions; |in |simple |terms, |this |is |an |estimate |of |the |time |needed |to |collect
|the |accounts |receivable.
ACF |- |CORRECT |ANSWER✔✔-Administration |for |Children |and |Families; |one |of |the |DHHS
Operating |Divisions.
ACL |- |CORRECT |ANSWER✔✔-Administration |for |Community |Living; |one |of |the |DHHS |Operating
Divisions.
actual |or |expressed |consent |- |CORRECT |ANSWER✔✔-written |or |oral |agreement |by |the |patient
|to
the |treatment |outlined.
,acute |inpatient |- |CORRECT |ANSWER✔✔-a |level |of |healthcare |delivered |to |patients |
experiencing
acute |illness |or |trauma; |it |generally |occurs |in |a |hospital |or |emergency |room |and |is |generally |
short-term |care |rather |than |long-term |or |chronic |care.
ADC |- |CORRECT |ANSWER✔✔-average |daily |census; |the |average |number |of |inpatients |
maintained |in |the |hospital |each |day |for |a |specific |period |of |time.
ADRR |- |CORRECT |ANSWER✔✔-Average |Days |of |Revenue |in |Accounts |Receivable; |also |known |
as |Accounts |Receivable |(AR) |Days |Outstanding; |an |estimate, |using |average |current |revenues, |
of |the |days |required |to |turn |over |the |accounts |receivable |under |normal |operating |conditions; |
in |simple |terms, |this |is |an |estimate |of |the |time |needed |to |collect |the |accounts |receivable.
Advance |Beneficiary |Notice |- |CORRECT |ANSWER✔✔-the |Advance |Beneficiary |Notice |of |
Noncoverage; |a |form |given |to |a |Medicare |beneficiary |before |services |are |furnished |when |a |
service |does |not |meet |or |is |not |expected |to |meet |medical |necessity.
AFDC |- |CORRECT |ANSWER✔✔-Aid |to |Families |with |Dependent |Children; |a |financial |assistance
program |provided |by |DHHS.
agents |- |CORRECT |ANSWER✔✔-individuals |who |help |consumers |and |small |businesses |
complete
the |application |process |and |enroll |in |healthcare |coverage |through |the |Marketplace; |they |are |
able |to |make |recommendations |about |coverage |and |may |only |sell |plans |from |specific |health |
insurance |companies.
AHA |- |CORRECT |ANSWER✔✔-the |American |Hospital |Association.
AHRQ |- |CORRECT |ANSWER✔✔-Agency |for |Healthcare |Research |and |Quality; |one |of |the |DHHS
Operating |Divisions.
, ALOS |- |CORRECT |ANSWER✔✔-average |length |of |stay; |a |metric |calculated |by |dividing |the |total
number |of |patient |days |by |the |number |of |discharges.
ancillary |services |- |CORRECT |ANSWER✔✔-services |other |than |routine |room |and |board |charges
that |are |incidental |to |the |hospital |stay; |they |include |operating |room; |anesthesia; |blood |
administration; |pharmacy; |radiology; |laboratory; |medical, |surgical, |and |central |supplies; |
physical, |occupational, |speech |pathology, |and |inhalation |therapies; |and |other |diagnostic |
services.
ANSI |- |CORRECT |ANSWER✔✔-the |American |National |Standards |Institute.
APC |- |CORRECT |ANSWER✔✔-ambulatory |payment |classification; |a |payment |methodology |in
which |services |paid |under |the |prospective |payment |system |are
classified |into |groups |that |are |similar |clinically |and |in |terms |of |the
resources |they |require; |a |payment |rate |is |established |for |each |APC.
APR |- |CORRECT |ANSWER✔✔-annual |percentage |rate; |one |of |the |elements |of |disclosure |
required |by |the |Truth |in |Lending |Act.
assignment |of |benefits |- |CORRECT |ANSWER✔✔-a |written |authorization, |signed |by |the |
policyholder |(or |the |patient, |in |the |absence |of |the |policyholder) |to |an |insurance |company, |to |
pay |benefits |directly |to |the |provider; |when |assignment |is |not |accepted, |the |payment |will |be |
sent |to |the |patient |and |the |provider |will |have |to |collect |it.
ATB |- |CORRECT |ANSWER✔✔-aged |trial |balance; |a |resource |for |internal |collection |efforts.
ATSDR |- |CORRECT |ANSWER✔✔-Agency |for |Toxic |Substances |and |Disease |Registry; |one |of |the
Correct Answers
CRCS |- |CORRECT |ANSWER✔✔-Certified |Revenue |Cycle |Specialist
AAHAM |- |CORRECT |ANSWER✔✔-The |American |Association |of |Healthcare |Administrative |
Management
1-Day |Rule |- |CORRECT |ANSWER✔✔-a |requirement |that |all |diagnostic |or |outpatient |services
furnished |in |connection |with |the |principle |admitting |diagnosis |within |one |day |prior |to |the |
hospital |admission |are |bundled |with |the |inpatient |services |for |Medicare |billing.
3-Day |Rule |- |CORRECT |ANSWER✔✔-a |requirement |that |all |diagnostic |or |outpatient |services
furnished |in |connection |with |the |principle |admitting |diagnosis |within |three |days |prior |to |the |
hospital |admission |are |bundled |with |the |inpatient |services |for |Medicare |billing.
5010A1 |- |CORRECT |ANSWER✔✔-the |American |National |Standards |Institute |transaction |for |a
professional |claim |(the |electronic |equivalent |of |the |CMS |15000),
formerly |the |837P
837I |- |CORRECT |ANSWER✔✔-the |American |National |Standards |Institute |transaction |for |an
institutional |claim; |as |a |result |of |HIPAA, |it |is |replacing |the |electronic
UB-04.
837P |- |CORRECT |ANSWER✔✔-a |former |American |National |Standards |Institute |transaction |for |
a
,professional |claim |(the |electronic |equivalent |of |the |CMS |15000), |sincereplaced |by |the |5010A1.
ABN |- |CORRECT |ANSWER✔✔-the |Advance |Beneficiary |Notice |of |Noncoverage; |a |form |given |to
|a |Medicare |beneficiary |before |services |are |furnished |when |a |service |does |not |meet |or |is |not |
expected |to |meet |medical |necessity.
abuse |- |CORRECT |ANSWER✔✔-the |misuse |of |a |person, |substance, |service, |or |financial |matter |
such |that |harm |is |caused; |some |forms |of |healthcare |abuse |include |excessive |or |unwarranted |
use |of |technology, |pharmaceuticals, |and |services; |abuse |of |authority; |and |abuse |of |privacy, |
confidentiality, |or |duty |to |care; |it |also |includes |improper |billing |practices |(like |billing |Medicare |
instead |of |primary |insurer), |increasing |charges |to |Medicare |beneficiaries |but |not |to |other |
patients, |unbundling |of |services, |and |unnecessary |transfers |of
patients.
Accounts |Receivable |(AR) |Days |Outstanding |- |CORRECT |ANSWER✔✔-an |estimate, |using |
average |current |revenues, |of |the |days |required |to |turn |over |the |accounts |receivable |under |
normal |operating |conditions; |in |simple |terms, |this |is |an |estimate |of |the |time |needed |to |collect
|the |accounts |receivable.
ACF |- |CORRECT |ANSWER✔✔-Administration |for |Children |and |Families; |one |of |the |DHHS
Operating |Divisions.
ACL |- |CORRECT |ANSWER✔✔-Administration |for |Community |Living; |one |of |the |DHHS |Operating
Divisions.
actual |or |expressed |consent |- |CORRECT |ANSWER✔✔-written |or |oral |agreement |by |the |patient
|to
the |treatment |outlined.
,acute |inpatient |- |CORRECT |ANSWER✔✔-a |level |of |healthcare |delivered |to |patients |
experiencing
acute |illness |or |trauma; |it |generally |occurs |in |a |hospital |or |emergency |room |and |is |generally |
short-term |care |rather |than |long-term |or |chronic |care.
ADC |- |CORRECT |ANSWER✔✔-average |daily |census; |the |average |number |of |inpatients |
maintained |in |the |hospital |each |day |for |a |specific |period |of |time.
ADRR |- |CORRECT |ANSWER✔✔-Average |Days |of |Revenue |in |Accounts |Receivable; |also |known |
as |Accounts |Receivable |(AR) |Days |Outstanding; |an |estimate, |using |average |current |revenues, |
of |the |days |required |to |turn |over |the |accounts |receivable |under |normal |operating |conditions; |
in |simple |terms, |this |is |an |estimate |of |the |time |needed |to |collect |the |accounts |receivable.
Advance |Beneficiary |Notice |- |CORRECT |ANSWER✔✔-the |Advance |Beneficiary |Notice |of |
Noncoverage; |a |form |given |to |a |Medicare |beneficiary |before |services |are |furnished |when |a |
service |does |not |meet |or |is |not |expected |to |meet |medical |necessity.
AFDC |- |CORRECT |ANSWER✔✔-Aid |to |Families |with |Dependent |Children; |a |financial |assistance
program |provided |by |DHHS.
agents |- |CORRECT |ANSWER✔✔-individuals |who |help |consumers |and |small |businesses |
complete
the |application |process |and |enroll |in |healthcare |coverage |through |the |Marketplace; |they |are |
able |to |make |recommendations |about |coverage |and |may |only |sell |plans |from |specific |health |
insurance |companies.
AHA |- |CORRECT |ANSWER✔✔-the |American |Hospital |Association.
AHRQ |- |CORRECT |ANSWER✔✔-Agency |for |Healthcare |Research |and |Quality; |one |of |the |DHHS
Operating |Divisions.
, ALOS |- |CORRECT |ANSWER✔✔-average |length |of |stay; |a |metric |calculated |by |dividing |the |total
number |of |patient |days |by |the |number |of |discharges.
ancillary |services |- |CORRECT |ANSWER✔✔-services |other |than |routine |room |and |board |charges
that |are |incidental |to |the |hospital |stay; |they |include |operating |room; |anesthesia; |blood |
administration; |pharmacy; |radiology; |laboratory; |medical, |surgical, |and |central |supplies; |
physical, |occupational, |speech |pathology, |and |inhalation |therapies; |and |other |diagnostic |
services.
ANSI |- |CORRECT |ANSWER✔✔-the |American |National |Standards |Institute.
APC |- |CORRECT |ANSWER✔✔-ambulatory |payment |classification; |a |payment |methodology |in
which |services |paid |under |the |prospective |payment |system |are
classified |into |groups |that |are |similar |clinically |and |in |terms |of |the
resources |they |require; |a |payment |rate |is |established |for |each |APC.
APR |- |CORRECT |ANSWER✔✔-annual |percentage |rate; |one |of |the |elements |of |disclosure |
required |by |the |Truth |in |Lending |Act.
assignment |of |benefits |- |CORRECT |ANSWER✔✔-a |written |authorization, |signed |by |the |
policyholder |(or |the |patient, |in |the |absence |of |the |policyholder) |to |an |insurance |company, |to |
pay |benefits |directly |to |the |provider; |when |assignment |is |not |accepted, |the |payment |will |be |
sent |to |the |patient |and |the |provider |will |have |to |collect |it.
ATB |- |CORRECT |ANSWER✔✔-aged |trial |balance; |a |resource |for |internal |collection |efforts.
ATSDR |- |CORRECT |ANSWER✔✔-Agency |for |Toxic |Substances |and |Disease |Registry; |one |of |the
