Mixed Deck — All CHAA Topics Flashcards

During the registration workflow, what is the primary reason staff must verify a patient's identity using at least two identifiers?

Answer: To prevent wrong-patient errors and ensure patient safety

Using two patient identifiers (such as name and date of birth) is a Joint Commission National Patient Safety Goal designed to prevent mix-ups that could lead to wrong-patient treatment or test results.

When collecting a copayment at time of service, which best practice should patient access staff follow?

Answer: Collect the copay at check-in and provide a receipt

Collecting copayments at check-in is standard best practice and reduces the cost of back-end billing; a receipt documents the transaction for both parties.

What measures should patient access take to protect information on computer screens in public areas?

Answer: Use privacy screens, automatic logoff, screen positioning away from public view, and minimize visible PHI

HIPAA requires reasonable safeguards to protect PHI from incidental disclosure.

What does the suffix '-scopy' mean?

Answer: Visual examination using an instrument

'-Scopy' refers to visual examination using an instrument, as in colonoscopy (examination of the colon) or bronchoscopy (examination of the airways). Patient access staff regularly process prior authorizations for these diagnostic procedures.

What is 'patient identity verification' and what methods are used?

Answer: A multi-step process using government-issued photo ID, insurance card, and verbal verification of personal details to confirm the patient's identity

Patient identity verification is a multi-step process to confirm that the patient is who they claim to be. Methods include reviewing government-issued photo identification, comparing insurance card information, verbal verification of date of birth and address, and comparing information against existing records. Proper identity verification prevents medical identity theft, ensures accurate record matching, and supports patient safety.

What is a 'risk analysis' under the HIPAA Security Rule?

Answer: A comprehensive assessment of potential risks and vulnerabilities to the confidentiality, integrity, and availability of ePHI

A HIPAA risk analysis is a comprehensive assessment that identifies potential risks and vulnerabilities to the confidentiality, integrity, and availability of ePHI. It is a required administrative safeguard and the foundation of a HIPAA security program. The risk analysis must be ongoing, not a one-time event, and must lead to a risk management plan addressing identified threats.

What is TRICARE, and which population does it serve?

Answer: The healthcare program for active duty military, veterans, retirees, and their families

TRICARE is the DoD healthcare system serving military members, retirees, and dependents.

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 (Days in AR)

Days in accounts receivable (Days in AR) measures how long, on average, it takes to collect payments after services are rendered; a lower number indicates a more efficient revenue cycle.

A physician's office sends a referral with incomplete insurance information. What is the best approach?

Answer: Contact the referring office to obtain complete information before the patient's appointment

Proactive communication with the referring office ensures complete information is available, preventing registration delays and potential claim denials.

A patient refuses a blood transfusion citing religious beliefs. The attending physician believes the transfusion is medically necessary. The Patient Access associate's MOST appropriate action is to:

Answer: Document the refusal in the record and alert the clinical team and patient advocacy

A competent adult has the right to refuse treatment; the associate should document the refusal and notify appropriate clinical and advocacy staff to ensure the patient's rights are respected.

What does the root word 'nephro-' refer to?

Answer: Kidney

'Nephro-' comes from the Greek word for kidney. Nephrology is the branch of medicine dealing with kidney diseases, and nephrectomy is surgical removal of a kidney.

What is 'auto-verification' or 'batch eligibility' processing?

Answer: Automated electronic verification of insurance eligibility for a batch of scheduled patients before their appointments

Batch eligibility processing automatically verifies insurance eligibility for all patients scheduled for upcoming appointments, typically running overnight or at set intervals. This proactive approach identifies coverage issues days before the appointment, allowing staff to resolve problems in advance. It is more efficient than individually checking each patient at the time of registration.

What does the prefix 'tachy-' mean in medical terminology?

Answer: Fast

'Tachy-' means fast or rapid, as seen in 'tachycardia' (rapid heart rate). Patient access staff may encounter this term on triage notes and emergency admission records where heart rate abnormalities are documented.

Which document is required before providing a patient with a good faith estimate under the No Surprises Act?

Answer: A scheduled service or a patient request for an estimate

Under the No Surprises Act, facilities must provide good faith estimates to uninsured or self-pay patients upon scheduling or upon request.

What is a 'prior authorization list' and how should it be used?

Answer: A payer-specific list of services, procedures, and medications that require pre-approval, used to identify authorization needs during scheduling and verification

A prior authorization list is a payer-published list of specific services, procedures, diagnostic tests, and medications that require pre-approval before they can be performed. Patient access staff should reference this list during scheduling and eligibility verification to identify any authorization requirements. Missing a required authorization is one of the most common and preventable causes of claim denials.

Which of the following best distinguishes insurance eligibility verification from prior authorization?

Answer: Eligibility verification confirms that coverage is active; prior authorization confirms that a specific service is approved for payment

Eligibility verification answers 'Is the patient covered?' while prior authorization answers 'Will the payer approve this particular service?' Both are needed, but they are distinct steps in the revenue cycle workflow.

What does 'timely filing' refer to in the context of healthcare billing?

Answer: Submitting insurance claims within the payer's deadline to avoid denial

Timely filing refers to the deadline by which claims must be submitted to an insurance payer, typically ranging from 90 days to one year depending on the payer.

What does the suffix '-otomy' mean?

Answer: Surgical incision into

'-otomy' means a surgical incision into a body part. A tracheotomy is an incision into the trachea. It is important to distinguish '-otomy' (incision) from '-ectomy' (removal) when reviewing procedure orders during patient registration.

What is a 'contingency plan' under the HIPAA Security Rule?

Answer: A plan for responding to emergencies or disasters that could damage systems containing ePHI, including data backup, disaster recovery, and emergency operations

A HIPAA contingency plan addresses how an organization will respond to emergencies, disasters, or system failures that could affect ePHI. Required components include a data backup plan, a disaster recovery plan, and an emergency mode operations plan. The plan ensures that critical ePHI remains available and protected even during adverse events such as natural disasters, cyberattacks, or system failures.

What does the suffix '-algia' mean in medical terminology?

Answer: Pain

'-Algia' means pain. It appears in neuralgia (nerve pain), myalgia (muscle pain), and arthralgia (joint pain), helping clinicians describe a patient's chief complaint location.