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NHA CBCS CERTIFICATION
EXAM STUDY GUIDE
- abstracting: the extraction of specific data from a medical record, often for use
in an external database, such as a cancer registry
- abuse: practices that directly or indirectly result in unnecessary costs to the Medicare
program
- account number: number that identifies specific episode of care, date of service, or patient
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- accounts receivable department: Department that keeps track of what third-party
payers the provider is waiting to hear from and what patients are due to make a payment.
5. activity/status date: Indicates the most recent activity of an item.
6. actual charge: the amount the provider charges for the health care service
- Administration Simplification Compliance Act (ASCA): specifically prohibits any
payment by Medicare for services or medically necessary supplies that are not submitted electronically
- administrative services only (ASO) contract: Contract between employers and private
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insurers under which employers fund the plans themselves, and the private insurers administer the plans for the employers.
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9. Advance Beneficiary Notice of Noncoverage (ABN): Form provided if a provider
believes that a service may be declined because Medicare might consider it unnecessary.
10. aging report: Measures the outstanding balances in each account.
11. allowable charge: The amount an insurer will accept as full payment, minus
applicable cost sharing.
12. APC grouper: Helps coders determine the appropriate ambulatory payment
classification (APC) for an outpatient encounter.
- assignment of benefits: Contract in which the provider directly bills the payer and
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accepts the allowable charge.