Nha Ccma Exam 2024 (Actual Questions And Answers)

Nha Ccma Exam 2024 (Actual Questions And Answers) Advance Beneficiary Notice (ABN) - CORRECT ANSWER-A form provided to the patient when the provider believes Medicare will probably not pay for services received Allowed Amount - CORRECT ANSWER-The maximum amount a third-party payer will pay for a particular procedure or service Copayment - CORRECT ANSWER-a small fixed fee paid by the patient at the time of an office visit Coinsurance - CORRECT ANSWER-a provision under which both the insured and the insurer share the covered losses, typically 80:20 deductible - CORRECT ANSWER-specific amount of money a patient must pay out of pocket before the insurance carrier begins paying Explanation of Benefits - CORRECT ANSWER-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) - CORRECT ANSWER-Providers who agree to write off the difference between the amount charged by the provider and the approved fee established by the insurer Medicare - CORRECT ANSWER-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 - CORRECT ANSWER-U.S. government health insurance plan for all military personnel CHAMPVA - CORRECT ANSWER-covers surviving spouses and dependent children of veterans who died as a result of service-related disabilities Medicaid - CORRECT ANSWER-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 - CORRECT ANSWER-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 - CORRECT ANSWER-Standard insurance form used by all government and most commercial insurance payers. - 33 blocks - divided into three section CMS-1500 Section 1 - CORRECT ANSWER-Carrier Block: contains the address of the insurance carrier and is located at the top of the form CMS-1500 Section 2 - CORRECT ANSWER-Patient/insured section: contains information about the patient or insured; includes boxes 1-13 CMS-1500 Section 3 - CORRECT ANSWER-Physician/Supplier Section: contains information about the physician or supplier: boxes 14-33 Supine Position - CORRECT ANSWERDorsal Recumbent Position - CORRECT ANSWER