NHA CCMA Exam Questions & 100% Verified
Answers | Latest Update | Already Graded A+
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
1|Page
,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
2|Page
,🗸🗸🗸: 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
3|Page
, 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
🗸🗸🗸:
4|Page
Answers | Latest Update | Already Graded A+
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
1|Page
,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
2|Page
,🗸🗸🗸: 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
3|Page
, 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
🗸🗸🗸:
4|Page
