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NHA CCMA Exam (2022/2023) with Certified Solutions
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Advance Beneficiary Notice (ABN) A form provided to the patient when the provider believes Medicare will probably not pay for services received Allowed Amount The maximum amount a third-party payer will pay for a particular procedure or service Copayment a small fixed fee paid by the patien...

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  • October 9, 2023
  • 40
  • 2023/2024
  • Exam (elaborations)
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  • nha ccma exam with certified solution

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NHA CCMA Exam (2022/2023) with
Certified Solutions
Advance Beneficiary Notice (ABN) ✔✔A form provided to the patient when the provider

believes Medicare will probably not pay for services received




Allowed Amount ✔✔The maximum amount a third-party payer will pay for a particular

procedure or service




Copayment ✔✔a small fixed fee paid by the patient at the time of an office visit




Coinsurance ✔✔a provision under which both the insured and the insurer share the covered

losses, typically 80:20




deductible ✔✔specific amount of money a patient must pay out of pocket before the insurance

carrier begins paying




Explanation of Benefits ✔✔a form created by the insurance company to explain what charges

were covered, denied, or need more documentation based on the claims submitted by the

physician's office

,Participating provider (PAR) ✔✔Providers who agree to write off the difference between the

amount charged by the provider and the approved fee established by the insurer




Medicare ✔✔A federal program of health insurance for persons 65 years of age and older by

Part A (hospitalization) or Part B (routine medical office visits)




Tricare ✔✔U.S. government health insurance plan for all military personnel




CHAMPVA ✔✔covers surviving spouses and dependent children of veterans who died as a

result of service-related disabilities




Medicaid ✔✔provides health insurance to the medically indigent population through a cost-

sharing program between federal and state governments for those who meet specific eligibility

criteria




Managed Care ✔✔is an umbrella term for plans that provide health care in return for preset

scheduled payments and coordinated care through a defined network of providers and hospitals

,CMS-1500 form ✔✔Standard insurance form used by all government and most commercial

insurance payers.

- 33 blocks

- divided into three section




CMS-1500 Section 1 ✔✔Carrier Block: contains the address of the insurance carrier and is

located at the top of the form




CMS-1500 Section 2 ✔✔Patient/insured section: contains information about the patient or

insured; includes boxes 1-13




CMS-1500 Section 3 ✔✔Physician/Supplier Section: contains information about the physician

or supplier: boxes 14-33




Supine Position ✔✔




Dorsal Recumbent Position ✔✔

, Sims' Position ✔✔




Knee-elbow position ✔✔




Fowler's Position ✔✔




Lithotomy Position ✔✔




Epidural Injection ✔✔epidural space of the spine




Intra-arterial Injection ✔✔injection into an artery (to break up clots)




Intra-articular Injection ✔✔injection into joint space




Intradermal Injection ✔✔Skin of the upper chest, forearms, upper pack. 5-15º angle




intramuscular injection ✔✔deltoid, vastus lateralis, ventrogluteal muscles

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