CCMA Exam 6 #1 Questions with correct answers
general practitioner - ✔✔Treat acute and chronic illnesses, provide preventative
care and education to all age patients. duties not confined to specific fields of
medicine, skills in treating in multiple health issues
family practitioner - ✔✔provides continuing and comprehensive care to
individuals and families across all ages
internists - ✔✔doctor who specializes in internal organs and systems but not
limited to this. can also give preventative care and can treat skin rashes to ear
infections (only adults)
allergies/immunologists - ✔✔treat immune system disorders
EX: asthma, eczema, allergies, insect stings, some autoimmune diseases
endocrinologists - ✔✔- Experts on hormones and metabolism.
- EX: diabetes, thyroid problems, infertility, calcium, and bone disorders
gastroenterologists - ✔✔specialize in digestive organs
AREAS: stomach, bowels, pancreas, liver, gallbladder) ISSUES: abdominal pain,
ulcers, diarrhea, jaundice, cancer in digestive organs, colonoscopy, colon cancer)
hematologists - ✔✔diseases of blood, spleen, and lymph glands (sickle cell,
anemia, hemophilia, leukemia)
,infectious disease specialist - ✔✔diagnose and treat infections in any part of your
body (fevers, Lyme disease, pneumonia, tuberculosis, HIV, aids)
oncologist - ✔✔cancer doctor
obstetrician/gynecologist - ✔✔OB/GYN - women's health, pregnancy, childbirth
etc.
opthamologists - ✔✔eye doctor
pathologists - ✔✔LAB DOCTORS - identify the causes of diseases by examining
body tissues and fluids under microscopes
pediatrician - ✔✔physician specializing in the treatment of babies and children
podiatrist - ✔✔feet and ankles
urologists - ✔✔specialize in disorders of the urinary tract
managed care plan - ✔✔a health insurance care plan that is designed to lower
costs for both the insurer and the consumer while maintaining a high standard of
care
TYPES OF MANAGED CARE PLANS: HMO, PPO, EPO, POS
,medicare - ✔✔people over 65 and people who are disabled under 65 (federally
sponsored)
Medicaid - ✔✔low income ( joint federal and state program)
tricare - ✔✔-government sponsored program
-authorized dependents of military personal receive medical care
workers comp - ✔✔system of law protecting employees against loss of wages and
cost of medical care unless employee was proven negligent
civilian health and medical program of the department of veterans affairs
(CHAMPVA) - ✔✔-healthcare program where VA pays for healthcare services and
supplies
-can be eligible for tricare
-can be spouse or child of disabled vet, surviving spouse or child of a vet who died
on the line of duty or died from a service disability
private insurance - ✔✔health insurance provided by a private company, often
through employer or purchased by an individual that helps pay for healthcare
services
ACOs (accountable care organizations) - ✔✔Team of providers that coordinate
care and take responsibility for total costs. Meet quality + spend below
benchmark → share savings; overspend (some models) → pay back.
, collaborative care model - ✔✔offers one approach to integration in which
primary care providers, care managers, and psychiatric consultants work together
to provide care and monitor patients' progress
pay for performance (P4P) or value based purchasing - ✔✔financial incentives to
physicians, hospitals, medical groups, and other health care providers for meeting
certain performance measures
advanced beneficiary notice - ✔✔form given to a Medicare patient before a
service is performed when they think Medicare won't cover it, so if you want the
procedure you have to pay out of pocket
allowed charge (allowable amount) - ✔✔max amount an insurance company will
pay for a medical service
coinsurance - ✔✔the % of a medical bill that the patient pays after the deductible
has been met
-CO - you share cost with insurance
copayment - ✔✔flat fee you pay for a health care service
deductibles - ✔✔the amt you pay out of pocket before your insurance starts
paying
general practitioner - ✔✔Treat acute and chronic illnesses, provide preventative
care and education to all age patients. duties not confined to specific fields of
medicine, skills in treating in multiple health issues
family practitioner - ✔✔provides continuing and comprehensive care to
individuals and families across all ages
internists - ✔✔doctor who specializes in internal organs and systems but not
limited to this. can also give preventative care and can treat skin rashes to ear
infections (only adults)
allergies/immunologists - ✔✔treat immune system disorders
EX: asthma, eczema, allergies, insect stings, some autoimmune diseases
endocrinologists - ✔✔- Experts on hormones and metabolism.
- EX: diabetes, thyroid problems, infertility, calcium, and bone disorders
gastroenterologists - ✔✔specialize in digestive organs
AREAS: stomach, bowels, pancreas, liver, gallbladder) ISSUES: abdominal pain,
ulcers, diarrhea, jaundice, cancer in digestive organs, colonoscopy, colon cancer)
hematologists - ✔✔diseases of blood, spleen, and lymph glands (sickle cell,
anemia, hemophilia, leukemia)
,infectious disease specialist - ✔✔diagnose and treat infections in any part of your
body (fevers, Lyme disease, pneumonia, tuberculosis, HIV, aids)
oncologist - ✔✔cancer doctor
obstetrician/gynecologist - ✔✔OB/GYN - women's health, pregnancy, childbirth
etc.
opthamologists - ✔✔eye doctor
pathologists - ✔✔LAB DOCTORS - identify the causes of diseases by examining
body tissues and fluids under microscopes
pediatrician - ✔✔physician specializing in the treatment of babies and children
podiatrist - ✔✔feet and ankles
urologists - ✔✔specialize in disorders of the urinary tract
managed care plan - ✔✔a health insurance care plan that is designed to lower
costs for both the insurer and the consumer while maintaining a high standard of
care
TYPES OF MANAGED CARE PLANS: HMO, PPO, EPO, POS
,medicare - ✔✔people over 65 and people who are disabled under 65 (federally
sponsored)
Medicaid - ✔✔low income ( joint federal and state program)
tricare - ✔✔-government sponsored program
-authorized dependents of military personal receive medical care
workers comp - ✔✔system of law protecting employees against loss of wages and
cost of medical care unless employee was proven negligent
civilian health and medical program of the department of veterans affairs
(CHAMPVA) - ✔✔-healthcare program where VA pays for healthcare services and
supplies
-can be eligible for tricare
-can be spouse or child of disabled vet, surviving spouse or child of a vet who died
on the line of duty or died from a service disability
private insurance - ✔✔health insurance provided by a private company, often
through employer or purchased by an individual that helps pay for healthcare
services
ACOs (accountable care organizations) - ✔✔Team of providers that coordinate
care and take responsibility for total costs. Meet quality + spend below
benchmark → share savings; overspend (some models) → pay back.
, collaborative care model - ✔✔offers one approach to integration in which
primary care providers, care managers, and psychiatric consultants work together
to provide care and monitor patients' progress
pay for performance (P4P) or value based purchasing - ✔✔financial incentives to
physicians, hospitals, medical groups, and other health care providers for meeting
certain performance measures
advanced beneficiary notice - ✔✔form given to a Medicare patient before a
service is performed when they think Medicare won't cover it, so if you want the
procedure you have to pay out of pocket
allowed charge (allowable amount) - ✔✔max amount an insurance company will
pay for a medical service
coinsurance - ✔✔the % of a medical bill that the patient pays after the deductible
has been met
-CO - you share cost with insurance
copayment - ✔✔flat fee you pay for a health care service
deductibles - ✔✔the amt you pay out of pocket before your insurance starts
paying
