The CHAM examination addresses the following subject matter. Candidates are required to demonstrate proficiency by answering questions that evaluate their knowledge of facts, concepts, and processes required to complete the tasks described below.

 

I.          Pre-Encounter (45%)

 

A. Customer Service

1.         Quality Service and Customer Satisfaction

2.   Staff who are Caring, Compassionate, Knowledgeable, Respect Privacy, and have Good Communication Skills

 

B. Referral/Transfer Services

1.         Inpatient and Outpatient Transfers

2.         Intra- and Inter-Facility Referrals

3.         Contractual, Legal, and Regulatory Requirements

 

C. Resource Scheduling

1.   Assessing Customer Expectations and Special Needs of the Patient

(e.g., Age Specific, Interpretive Service, and Physical Needs)

2.         Arranging and Scheduling Location, Equipment, and/or Staff

3.         Documentation of Pertinent Schedule Information

4.         Confirmation of Service for a Specific Date and Time

 

D. Pre-Registration

1.         Patient Account Creation

2.         Medical Record Validation/initiation to ensure Identification and Safety

 

E. Clinical Prerequisites

1.         Requirements based on Physician Orders, Protocols, and/or Medical Necessity

2.         Testing, Prep, and Procedure Requirements (e.g., Fasting and/or Labs)

 

F.   Financial Clearance

1.         Accurate Payer Identified

2.         Assuring Payer Requirements are met

3.         Informing and/or Collecting Customer Financial Obligations prior to Service

4.         Regulatory Agencies and Compliance Standards (e.g., Federal, State, and Local)

5.         Financial Counseling

 

G. Verification of Benefits

 

H. Payer Authorization

 

II.          Encounter (35%)

 

A. Patient Check-in, Admission, Registration

1.         Processes related to Registering Patient

a.   Validating or obtaining demographic, admission source, clinical, and financial information

b.   Required forms for patient registration (e.g., The Patient Bill of Rights and Responsibilities)

c.   Obtaining consents, signatures, and other required documents

d.   Order processing

e.   Medical terminology and medical coding

2.         Level of Care Requirements (e.g., Inpatient, Observation, and Outpatient)

3.         Payer Plan Coverage (e.g., Governmental Payers, Workers Compensation, and Insurance)

4.         Coordination of Benefits

 

B. Guest Services

1.         Services to help reduce Patient and Family Stress and increase Customer Satisfaction

2.         Internal and External Wayfinding (e.g., Transportation, Parking, and Drop-off)

3.         Providing Information needed for Patient & Family (Room Number, Visiting Hours, etc.)

4.         Release of Information Limitations

5.         Service Recovery Measures (e.g., Validating Parking and Free Meal Tickets)

 

C. Discharge/Departure

1.         Collection and/or Financial Counseling

 

D. Revenue Cycle

1.         Data Elements necessary for Accurate Billing

2.         Case Management, Utilization Review, and Clinical Documentation

3.         Health Information Management (HIM)/Medical Records 

4.         Billing, Follow-up, Cash Posting, and Accounts Receivable

5.         Collection of Payment and Knowledge of Average Collection Periods

6.         Denials Management

7.         Managed Care Contracting

 

E. Information Systems

1.         Timely Input of Data

2.         Impact of Patient Management System Transactions (e.g., Electronic Medical Records and Ancillary Systems)

3.         System Down Time and Recovery

 

III.         Future Development (20%)

 

A. Statistical Reporting

1.         Benchmarking Processes to improve Outcomes through Education, Performance Feedback, and improved Systems/Devices

2.         Summarizing Information in a Timely Manner for Process Improvement, Administration, and Management

3.         Trending Areas of Interest (e.g., Payment, Patient Flow, and Denials)

 

B. Resource Management and Productivity

1.         Managing Resources to Accommodate Customer Needs (e.g., Facility, Budget)

2.         Responsive to Delays and Unexpected Changes

3.         Disaster Preparedness

 

C. Customer Satisfaction and Retention 

1.         Courtesy, Respect, and Patient Confidentiality

2.         Measures of Customer Satisfaction

3.         Anticipating and Managing Customer Expectations

 

D. Staff Education and Competency

1.         Performance Standards Development

2.         Staff Education to meet Desired Outcomes

3.         Ensuring Staff is competent in Assigned Responsibilities

 

E. Quality and Accuracy

1.         Monitoring and Auditing Selected Processes

2.         Reporting and Utilizing Information to Impact Change

 

F.   Leadership and Management

1.         Customer Relationship Management (e.g., Physician, Payers, Departments)

2.         Human Resource Management

3.         Effective Communication

4.         Strategic Planning

5.         Professional Development and Continuing Education

6.         Regulatory Compliance