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AAHAM CRCS-P Study Guide With 100% Correct Solutions
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AAHAM CRCS-P Study Guide With 100% Correct Solutions
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AAHAM CRCS-P Study Guide With 100%Correct Solutions
CRCS CORRECT ANSWERS Certified Revenue Cycle Specialist
AAHAM CORRECT ANSWERS The American Association of Healthcare Administrative
Management
1-Day Rule CORRECT ANSWERS 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 ANSWERS 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 ANSWERS the American National Standards Institute transaction
for a
professional claim (the electronic equivalent of the CMS 15000),
formerly the 837P
837I CORRECT ANSWERS the American National Standards Institute transaction for
an
institutional claim; as a result of HIPAA, it is replacing the electronic
UB-04.
837P CORRECT ANSWERS a former American National Standards Institute
transaction for a
professional claim (the electronic equivalent of the CMS 15000), sincereplaced by the
5010A1.
ABN CORRECT ANSWERS 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 ANSWERS 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 ANSWERS 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 ANSWERS Administration for Children and Families; one of the DHHS
Operating Divisions.
ACL CORRECT ANSWERS Administration for Community Living; one of the DHHS
Operating
Divisions.
actual or expressed consent CORRECT ANSWERS written or oral agreement by the
patient to
the treatment outlined.
acute inpatient CORRECT ANSWERS 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 ANSWERS average daily census; the average number of inpatients
maintained in the hospital each day for a specific period of time.
ADRR CORRECT ANSWERS 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 ANSWERS 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 ANSWERS Aid to Families with Dependent Children; a financial
assistance
program provided by DHHS.
agents CORRECT ANSWERS 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 ANSWERS the American Hospital Association.
AHRQ CORRECT ANSWERS Agency for Healthcare Research and Quality; one of the
DHHS
Operating Divisions.
ALOS CORRECT ANSWERS average length of stay; a metric calculated by dividing the
total
number of patient days by the number of discharges.
ancillary services CORRECT ANSWERS 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 ANSWERS the American National Standards Institute.
APC CORRECT ANSWERS 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 ANSWERS annual percentage rate; one of the elements of disclosure
required by the Truth in Lending Act.
assignment of benefits CORRECT ANSWERS 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 ANSWERS aged trial balance; a resource for internal collection efforts.
ATSDR CORRECT ANSWERS Agency for Toxic Substances and Disease Registry;
one of the
DHHS Operating Divisions.
average daily census CORRECT ANSWERS the average number of inpatients
maintained in the
hospital each day for a specific period of time.
average daily revenue CORRECT ANSWERS the average amount of revenue or
charges
generated each day over a specified period of time.
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