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What does the acronym BAA stand for in the context of a HIPAA-covered RCM company?

Billing Authorization Agreement

Business Associate Agreement

Billing Audit Assessment

Broker Affiliation Arrangement

to track

2026 Statistics

Key Facts: CHBME Exam

Exam Questions

HBMA Candidate Handbook

Time Limit

HBMA CHBME format

75%

Passing Score (typical)

HBMA certification

15 CEUs

Required Before Exam

HBMA prerequisite

45 Credits

Renewal Every 3 Years

HBMA maintenance

$350

Application Fee

HBMA pricing

The CHBME exam is HBMA's executive credential for healthcare billing company leadership. It contains 75 questions with a 2-hour time limit and typically requires 75% to pass. Candidates must earn 15 CEUs through HBMA-sponsored programs before sitting for the exam, and maintain certification with 45 credits every three years. Core domains include business operations, compliance (OIG 7 elements, HIPAA, False Claims Act, Anti-Kickback, Stark), HR and labor law, finance and accounting (including ASC 606), technology and interoperability (EDI, clearinghouses, FHIR, cybersecurity), and client acquisition and retention.

Sample CHBME Practice Questions

Try these sample questions to test your CHBME exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1What does the acronym BAA stand for in the context of a HIPAA-covered RCM company?

A.Billing Authorization Agreement

B.Business Associate Agreement

C.Billing Audit Assessment

D.Broker Affiliation Arrangement

Explanation: A Business Associate Agreement (BAA) is a HIPAA-required contract between a covered entity and any vendor that creates, receives, maintains, or transmits PHI on its behalf. RCM companies must execute BAAs with every client practice.

2Which fee model charges the billing company a percentage of the dollars actually collected from payers and patients?

A.Per-claim pricing

B.Percentage of collections

C.Per member per month (PMPM)

D.Flat monthly fee

Explanation: Percentage of collections is the most common RCM fee model where the billing company earns a stated percentage (often 4-9%) of payments received. It aligns incentives with client cash flow.

3Under the HITECH Act, how many days does a covered entity have to notify affected individuals of a breach of unsecured PHI?

A.30 days

B.45 days

C.60 days

D.90 days

Explanation: HITECH requires notification to affected individuals without unreasonable delay and no later than 60 calendar days after discovery of the breach.

4A breach affecting how many individuals triggers concurrent notification to HHS and prominent media outlets?

A.100 or more

B.250 or more

C.500 or more

D.1,000 or more

Explanation: HIPAA requires that breaches affecting 500 or more individuals be reported to HHS without unreasonable delay (and no later than 60 days) AND to prominent media outlets serving the affected state or jurisdiction.

5Which KPI measures the average number of days a claim remains unpaid after date of service?

A.Net collection rate

B.Days in accounts receivable

C.Clean claim rate

D.First-pass acceptance

Explanation: Days in AR measures the average time from service to payment. It is the primary cash-flow KPI and is calculated as (Total AR / Average Daily Charges).

6Under the 2022 No Surprises Act, what must providers give to uninsured or self-pay patients before scheduled services?

A.A Good Faith Estimate

B.A Notice of Privacy Practices

C.An Advance Beneficiary Notice

D.A Letter of Protection

Explanation: The No Surprises Act requires providers to furnish uninsured/self-pay patients a Good Faith Estimate (GFE) of expected charges before scheduled care.

7Which federal statute prohibits offering or receiving remuneration to induce referrals for items or services paid by federal healthcare programs?

A.Stark Law

B.Anti-Kickback Statute

C.False Claims Act

D.Civil Monetary Penalties Law

Explanation: The Anti-Kickback Statute (AKS) is an intent-based criminal statute prohibiting remuneration to induce federal healthcare program referrals. Violations can be criminal (fines + imprisonment) and trigger FCA liability.

8Under the OIG's model compliance program, which role should report directly to the CEO or board to preserve independence?

A.Chief Financial Officer

B.Compliance Officer

C.Chief Medical Officer

D.Director of Operations

Explanation: OIG guidance emphasizes that the Compliance Officer must have direct access and reporting to the CEO and board (often via an audit/compliance committee) to ensure independence from operational pressures.

9Which accounting standard governs revenue recognition for RCM service contracts?

A.ASC 605

B.ASC 606

C.ASC 842

D.ASC 326

Explanation: ASC 606 (Revenue from Contracts with Customers) is the five-step model used by RCM companies to identify contracts, identify performance obligations, determine and allocate transaction price, and recognize revenue when obligations are satisfied.

10What EDI transaction set is used to submit a professional healthcare claim?

A.835

B.837P

C.270

D.277CA

Explanation: The 837P (Professional) transaction is the HIPAA-mandated EDI format for submitting professional claims. The 837I is used for institutional claims and 837D for dental.

About the CHBME Exam

The CHBME is the executive-level credential from HBMA for billing company owners, C-suite leaders, and senior managers in third-party medical billing and revenue cycle management (RCM) companies. It validates mastery of strategic operations, HIPAA enterprise governance, OIG compliance programs, HR and labor law, financial management, technology strategy, sales, and client contracting.

Questions

75 scored questions

Time Limit

2 hours

Passing Score

75%

Exam Fee

$350 application + annual maintenance (HBMA (Healthcare Business Management Association))

CHBME Exam Content Outline

High

Business Operations and Strategy

Strategic planning, RCM company scaling, client contracts, BAAs, pricing models, and M&A

High

Compliance and Regulatory (OIG, HIPAA, Fraud)

OIG 7 elements, HIPAA Privacy/Security, False Claims Act, Anti-Kickback, Stark, No Surprises Act

High

Financial Management and Accounting

P&L, cash flow, ASC 606 revenue recognition, KPIs, PE investment, tax structure

Medium

Human Resources and Labor Law

FLSA, FMLA, Title VII, ADA, remote workforce, offshore outsourcing, productivity management

Medium

Technology and Cybersecurity

PM/EHR systems, EDI transactions, clearinghouses, AI/RPA, HICP, 405(d), ransomware response

Foundation

Sales, Marketing, and Client Success

B2B prospecting, RFPs, SLAs, QBRs, NPS, client retention, value-based care contracts

How to Pass the CHBME Exam

What You Need to Know

Passing score: 75%
Exam length: 75 questions
Time limit: 2 hours
Exam fee: $350 application + annual maintenance

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CHBME Study Tips from Top Performers

1Memorize the OIG 7 elements of an effective compliance program and how the compliance officer must have independent reporting authority

2Know HIPAA breach notification deadlines cold: 60 days to notify affected individuals, and breaches affecting 500+ require HHS + media notification

3Distinguish the False Claims Act (billing fraud), Anti-Kickback Statute (remuneration for referrals), and Stark Law (physician self-referral for DHS)

4Study ASC 606 revenue recognition for RCM companies — performance obligations are satisfied when cash is collected for clients, not when claims are submitted

5Review the Change Healthcare 2024 cyber incident as a case study in vendor concentration risk, BAA exposure, and cash flow resilience

Frequently Asked Questions

What is the CHBME exam format?

The CHBME exam consists of 75 multiple-choice questions with a 2-hour time limit, administered at in-person HBMA events. Candidates must earn 15 continuing education units (CEUs) through HBMA-sponsored programs before sitting for the exam, and a passing score of approximately 75% is required.

Who should pursue the CHBME credential?

The CHBME is designed for billing company owners, C-suite executives, senior managers, and directors at third-party medical billing and RCM companies. Typical candidates have 5+ years of healthcare billing experience with management responsibility and are active HBMA members.

How much does the CHBME cost?

The CHBME program has a $350 application fee, a $150 annual maintenance fee, and a reexamination fee of $99 for members or $198 for non-members. HBMA membership dues and the cost of CEU programs are additional. Total investment is typically $700 to $1,500 in the first year.

What does the CHBME exam cover?

Content spans strategic business operations, RCM company management, client contracts and BAAs, OIG compliance programs (including the 7 elements), HIPAA Privacy and Security at enterprise scale, HR and labor law (FLSA, FMLA, Title VII), financial management (ASC 606, KPIs, PE investment), technology strategy (EHR/PM, EDI, cybersecurity under HICP and 405(d)), and sales/client retention.

How is CHBME certification maintained?

Certified professionals must pay an annual maintenance fee at the beginning of each calendar year and complete 45 continuing education credits within every three-year cycle. Credits come from HBMA-sponsored educational programming, the annual conference, webinars, and approved external activities.

How should I study for the CHBME in 2026?

Focus on executive-level business judgment rather than tactical billing. Master the OIG 7 compliance elements, HIPAA breach notification timelines, False Claims Act / Anti-Kickback / Stark Law distinctions, ASC 606 revenue recognition for RCM services, the 2024 FTC non-compete ruling status, Change Healthcare cyber incident lessons, No Surprises Act IDR, and value-based care contracting.

How does CHBME differ from CPB or CRCE?

CPB (AAPC) validates tactical medical billing skills. CRCE (AAHAM) covers hospital revenue cycle execution. CHBME is executive-level for billing company leadership — it emphasizes strategic planning, compliance program oversight, business management, HR/labor law, finance, and client contracting rather than day-to-day claim processing.