CHAA Revenue Cycle Management

Question 1

Which phase of the revenue cycle begins when a patient schedules an appointment?

Accepted Answer

Pre-encounter

Answer

The pre-encounter phase starts when a patient first contacts the facility, including scheduling. This phase involves gathering demographic and insurance information before the patient arrives. Proper handling at this stage reduces downstream billing errors.

Question 2

What is the primary purpose of charge capture in the revenue cycle?

Accepted Answer

To record all billable services provided to a patient

Answer

Charge capture is the process of recording all services, procedures, and supplies provided to a patient so they can be billed accurately. Missing charges lead to revenue leakage. This step bridges clinical documentation and billing.

Question 3

What does 'clean claim' mean in healthcare billing?

Accepted Answer

A claim submitted without any errors or missing information

Answer

A clean claim is one that contains all required information, is free of errors, and can be processed without additional information from the provider. Clean claims result in faster reimbursement. The industry benchmark for clean claim rates is typically above 95%.

Question 4

Which department typically handles denied claims in the revenue cycle?

Accepted Answer

Patient financial services or billing

Answer

Patient financial services or the billing department is responsible for managing denied claims, including investigating the reason for denial and submitting appeals. They work to recover revenue that would otherwise be lost. Effective denial management is critical to financial performance.

Question 5

What is the typical order of revenue cycle steps?

Accepted Answer

Scheduling, registration, charge capture, claims submission, payment posting, collections

Answer

The revenue cycle follows a logical flow from patient scheduling through registration, service delivery with charge capture, claims submission to payers, payment posting when reimbursement is received, and finally collections for outstanding balances. Each step builds on the previous one.

CHAA - Certified Healthcare Access Associate Practice Test

CHAA - Certified Healthcare Access Associate Practice Test

CHAA Revenue Cycle Management