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CRCS Chapter 1

AAHAM CRCS Certification Chapter 1

QuestionAnswer
What are the two main governing bodies affecting healthcare change? 1. Centers for Medicare & Medicaid Services (CMS) 2. Office of Inspector General (OIG)
What does CMS stand for? Centers for Medicare & Medicaid Services
What does OIG stand for? Office of Inspector General
What does HHS stand for? U.S. Department of Health and Human Services
What does the U.S. Department of Health and Human Services do? The are the U.S. government's principal agency for protecting the health of all Americans and provide essential human services.
What are the HHS Operating Divisions? 1. NIH 2. FDA 3. CDC 4. ATSDR 5. IHS 6. HRSA 7. SAM-HSA 8. AHRQ 9. CMS 10. ACF 11. ACL
What does NIH stand for? National Institutes of Health
What does FDA stand for? Food and Drug Administration
What does CDC stand for? Centers for Disease Control and Prevention
What does ATSDR stand for? Agency for Toxic Substances and Disease Registry
What does IHS stand for? Indian Health Service
What does HRSA stand for? Health Resources and Services Administration
What does SAM-HSA stand for? Substance Abuse and Mental Health Services Administration
What does AHRQ stand for? Agency for Healthcare Research and Quality
What does the QIO Program do? It is a program that monitors and improves utilization and quality of care for Medicare beneficiaries.
What does ACF stand for? Administration for Children and Families
What does ACL stand for? Administration for Community Living
What agencies impact healthcare revenue cycle staff on a daily basis? CMS, QIO, OIG
What does QIO stand for? Quality Improvement Organization Program
What is Title XVIII? CMS Medicare Program
What is Title XIX? CMS Medicaid Program
What does CMS have oversight of? Medicare, Medicaid, States Children's health Insurance Program, the Health Insurance marketplace, and related quality assurance activities.
What is CMS responsible for (simple terms)? They are responsible for developing rules and regulations that govern Medicare and Medicaid. They also contract with entities who administer Medicare benefits in various regions of the country.
What does the Office of Inspector General do? It protects the integrity of HHS programs and the health and welfare of the beneficiaries of those programs. Major role in investigating fraud and abuse.
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