CHAA - Certified Healthcare Access Associate Revenue Cycle Management 2

Question 1

What is the primary purpose of obtaining prior authorization in the revenue cycle?

Accepted Answer

To confirm that a payer will cover a specific service before it is rendered

Answer

To verify a patient's demographic information before admission

Answer

To collect the patient's copayment at the time of service

Answer

To assign the correct diagnosis code to a procedure

Question 2

Which metric measures the average number of days it takes a healthcare organization to collect payment after a service is rendered?

Accepted Answer

Days in accounts receivable (A/R days)

Answer

Denial rate

Answer

Cost-to-collect ratio

Answer

Net collection rate

Question 3

What is the function of a remittance advice (RA) in the revenue cycle?

Accepted Answer

It explains how a payer processed a claim and what amount was paid or denied

Answer

It authorizes a provider to perform a clinical procedure

Answer

It documents the patient's consent for treatment

Answer

It records the charges entered by clinical staff after a service

Question 4

When a patient has both a primary and a secondary insurance plan, which process determines the order in which plans pay?

Accepted Answer

Coordination of benefits (COB)

Answer

Charge capture

Answer

Utilization review

Answer

Case mix analysis

Question 5

A hospital writes off a balance because it is contractually prohibited from billing the patient for the difference between its charge and the payer's allowed amount. This is known as a:

Accepted Answer

Contractual adjustment

Answer

Bad debt write-off

Answer

Charity care adjustment

Answer

Administrative denial

Question 6

Which step in the revenue cycle involves verifying that a patient's insurance is active and that the provider is in-network before the date of service?

Accepted Answer

Eligibility and benefits verification

Answer

Claims adjudication

Answer

Utilization management

Answer

Payment posting