Revenue Cycle Management 8 Flashcards
6 cards from real CHAA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Revenue Cycle Management 8 flashcards as text
Which metric measures the average number of days it takes a healthcare organization to collect payment after a service is provided?
Answer: Days in accounts receivable (AR)
Days in accounts receivable (AR) measures the average time from service delivery to payment collection, making it a key performance indicator for revenue cycle efficiency.
What is the primary function of a remittance advice (RA) in the revenue cycle?
Answer: To explain how a payer processed and adjudicated a submitted claim
A remittance advice (also called an explanation of benefits) details how the payer adjudicated the claim, including amounts paid, adjusted, or denied, allowing the provider to post payments and identify discrepancies.
In revenue cycle management, what does 'write-off' refer to?
Answer: Adjusting an uncollectable balance off the accounts receivable
A write-off is the formal removal of an uncollectable amount from accounts receivable, such as amounts exceeding contracted rates or balances deemed uncollectable after collection efforts.
Which of the following best describes 'coordination of benefits' (COB) in healthcare billing?
Answer: A method for determining the order in which multiple insurers pay on a claim
Coordination of benefits establishes which insurer pays first (primary) and which pays second (secondary) when a patient has multiple insurance plans, preventing duplicate payments.
What is the purpose of a healthcare organization's chargemaster (CDM)?
Answer: To list all services, supplies, and their associated charges billed by the facility
The chargemaster (charge description master) is the comprehensive list of every service, procedure, and supply a facility can bill, along with the associated standard charge, forming the foundation of the billing process.
Which term describes the process of verifying that the diagnosis codes submitted on a claim support the medical necessity of the billed procedure?
Answer: Medical necessity review
Medical necessity review evaluates whether the documented diagnosis codes justify the procedure or service billed, ensuring that payers will recognize the clinical appropriateness of the treatment provided.