NHA CCMA Exam 2022| Questions with 100% Correct Answers | Verified

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