NHA CCMA Administrative Assisting Review
1. Health Insurance Portability and Accountability Act (HIPAA): This act safeguards a patient's personal
and medical information, regulating the use and disclosure of personal health information (PHI).
2. Personal Health Information (PHI): This refers ...
1. Health Insurance Portability and Accountability Act (HIPAA): This act safeguards a patient's personal
and medical information, regulating the use and disclosure of personal health information (PHI).
2. Personal Health Information (PHI): This refers to any identifiable health information, such as name,
date of birth, phone number, and address, that is transmitted or stored electronically.
3. Usual Fee: The standard fees that a provider typically charges for services.
4. Reasonable Fee: A charge for services or procedures that require additional time or effort from the
provider due to their complexity.
5. Customary Fee: A range of fees charged by providers who possess similar training and experience
within the same geographic area.
6. Capitation: A predetermined amount paid to a healthcare provider by a third-party payer for each
enrolled individual over a specified period.
7. Source-Oriented: A medical record documentation format organized according to the source of the
information provided.
8. Stream Scheduling: Also known as time-specified scheduling, this method involves scheduling patients
at designated times with sufficient duration allocated for their visits, varying the time based on the
patient's condition.
9. Cluster Scheduling: This approach involves grouping patients with similar conditions into specific time
slots or days for their appointments.
10. Wave Scheduling: This strategy involves scheduling three patients during the first 30 minutes of the
hour, allowing them to be seen as they arrive. All patients scheduled for that hour are treated within the
same timeframe.
, 11. Modified Wave Scheduling: Patients are scheduled to arrive at intervals during the first half of the
hour, while the second half remains open for providers to catch up.
12. Open Hours Scheduling: This system permits patients to arrive at the doctor's office at their
convenience, with services provided on a first-come, first-served basis.
13. Which Type of Scheduling Involves Clustering: Scheduling all cardiac patients on Mondays and
Wednesdays and oncology patients on Tuesdays and Thursdays is an example of cluster scheduling.
14. Appointment System for Consistent Patient Flow: The wave scheduling system allows for flexibility
and helps maintain a consistent patient flow.
15. HCPCS Codes: These are procedure and service codes specific to Medicare and do not include
diagnosis codes.
16. Bundled Codes: Codes that combine one or more procedures or services into a single billing entity.
17. Multiple Coding: The practice of using several codes to fully describe a condition, particularly in
diagnosis coding.
18. Modifiers: These provide additional details or modify the description of procedures and services and
are part of valid CPT or HCPCS codes.
19. Coding to the Highest Level of Specificity: This approach ensures that third-party payers receive the
most precise diagnostic codes, minimizing the risk of insurance claims being denied.
20. Accountable Care Organization (ACO): A coalition of healthcare providers responsible for the quality,
cost, and overall care of Medicare beneficiaries enrolled in traditional fee-for-service programs.
21. Medicare: A federal health insurance program available for individuals aged 65 and older.
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