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CHAA Terms
| Term | Definition |
|---|---|
| Ability To Pay | A term that refers to a person's or a company's financial capacity to fulfill financial commitments. |
| Accreditation | Defined as a "self-assessment and external peer assessment process used by healthcare organizations to accurately assess their level of performance in relation to established standards and to implement ways to continuously improve. |
| Acute care | Medical attention given to patients with conditions of sudden onset that demand urgent attention or care of limited duration when the patient's health and wellness would deteriorate without treatment. |
| Acute Inpatient Care | A level of healthcare delivered to patients experiencing acute illness and trauma. Acute care is generally short-term (< 30 days). |
| Advance Beneficiary Notice of Non Coverage (ABN) | Written notice issued to a fee-for-service beneficiary before furnishing items or services that are usually covered by Medicare but are not expected to be paid in a specific instance for certain reasons, such as lack of medical necessity. |
| Advance Directive | Also known as a medical directive, healthcare directive or a living will, a legal document in which a person has outlined what they would like to be done if they are no longer able to make decisions for themselves due to incapacity or illness. |
| Ambulatory Services / Same-Day Surgery | Patient receives surgical treatment and is discharged from the facility within four to six hours of procedure. Ambulatory services can occur in an outpatient hospital department or in a freestanding ambulatory care facility. |
| Ancillary Services | Physician refers patients for scheduled and non-scheduled services such as radiology, laboratory. and/or other services that are performed in a hospital or clinic setting. Patients leave the facility once the services are completed. |
| Anti-Kickback Statue | Anti-fraud federal criminal statute that prohibits offering or exchange of anything of value in exchange for healthcare business referrals, including cash, rent, expensive hotel stays, etc. |
| Authorization Requirement | Certain services need authorizations while other procedures might not. Some insurance companies require a CPT code, so make sure you have that available. |
| Bad Debt | A monetary amount owed to a creditor that is unlikely to be paid. |
| Batch Processing | Execution of a series of jobs in a computer program without manual intervention; it is used to help maximize the use of computer resources and stabilize response time by performing system-intensive work during hours. |
| Benchmarking | The practice of comparing business processes and performance metrics to industry bests and best practices. |
| Carve Out | A decision to separately purchase a service, which is typically a part of an indemnity of an HMO plan. For example, an HMO may "carve out" the behavioral health benefits and select a specialie |
| Case Management | Coordination of services to help meet a patient's healthcare needs. |
| Centers for Medicare and Medicaid Services (CMS) | |
| CHAMPVA | The Civilian Health and Medical Program for the Veterans Administration is an insurance program for the families of veterans. |
| Charity care | Free or discounted medical care provided to patients who do no have the ability to pay for all or a part of medical costs due to limited income or financial hardship. |
| Clinical Trials | Scientifically controlled studies of the safety and effectiveness of a therapeutic agent using consenting human subjects. |
| COBRA | |
| Co-insurance | |
| Collections | The process of pursuing payments from people or businesses who have failed to pay their debts. |
| Condition code 44 | |
| Co-payment | |
| Coordination of Benefits (COB) | The distribution of compensation or coverage from more than one insurance policy. |
| Current Procedural Terminology | |
| Effective Listening | Effective listening is to listening to understand, not just hearing what is said. |
| electronic Protected Health Information (ePHI) | Any protected health information (PHI) as identified under HIPAA that is produced, saved, received or transferred in an electronic format. |
| Deductible | |
| Denial | |
| DNV Accreditation | |
| Downtown | Time the computer system is unavailable to users. |
| Electronic Health Record |
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