CMAA (CHAPTER 2)
List three ways a medical office can accommodate patients who have vision loss. - correct answer
✔✔Possible answers include having signage in Braille so the patient can find the office; having
documents in Braille and large print; and having modifications built into the computer if the patient is
asked to complete any forms electronically.
Why is health insurance important? - correct answer ✔✔Health insurance is important because it serves
as protections against protection against financial losses due to illness or injury. Insurance provides
financial support for medical needs, hospitalization, medically necessary diagnostic tests and procedures,
and many kinds of preventive services.
True or False: If preauthorization is required but not done, the insurance carrier will not pay for the
medical services provided - correct answer ✔✔True. Before certain procedures can be performed or a
patient hospitalized, many insurance companies require precertification or preauthorization. If this is not
done, insurance claims will be denied.
Who is considered a guarantor? - correct answer ✔✔(REASON) When the patient is the same as the
insured, the patient is also referred to as the guarantor.
(ANSWER) The patient who also is the owner of the primary insurance plan.
What is the birthday rule? - correct answer ✔✔The birthday rule applies to dependent children whose
parents have more than one insurance policy. Under the birthday rule, the health plan of the parent
whose birthday comes first in the calendar year is designated as the primary plan.
What are CPT codes used to describe? - correct answer ✔✔(REASON) Providers use CPT codes for
hospital inpatient and outpatient services.
(ANSWER) Services provided by providers
What is the HIPPA notice of privacy practices form? - correct answer ✔✔Under HIPPA, medical practices
are not allowed to release information unless patients first sign a notice of privacy practices form. This
form explains what's in in a patient's medical record, the patient's health information rights (e.g., request
a restriction on certain uses and disclosures of information, obtain a paper copy of the notice, and
amend, health record requests in writing), and the medical practice's responsibilities to the patient.
, Name three forms that may be found in a patient's medical record. - correct answer ✔✔Examples of
forms found in a patient's medical record include consent to release information, patient financial
responsibility form, and advance directives.
When are regular referrals needed? - correct answer ✔✔(REASON) A regular referral is when the
provider decides that the patient needs to see a specialist.
(ANSWER) A provider decides tat the patient needs to see a specialist.
What is included in a accurate, up-to-date medical record? - correct answer ✔✔(REASON) Medical
records contain all information relevant to patient medical care and insurance.
(ANSWER) All information relevant to patient medical care and insurance.
Name three types of information that falls under the heading "demographics". - correct answer
✔✔Three types of information under the heading "demographics" are name , address, and marital
status.
Why is it important to verify a patient's insurance? - correct answer ✔✔Verifying insurance ensures that
the patient is covered and determines the benefits that will be paid for routine and special procedures
and services. Verification also protects the provider and patient against unexpected medical care costs.
What are the two kinds of coding systems and how are they used? - correct answer ✔✔Clinical coding
systems, such as the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-
CM) and the upcomingICD-10-CM, track a patient's diagnosis and clinical history. Procedural coding
systems, such as Current Procedural Terminology (CPT) codes and the Healthcare Common Procedure
Coding System (HCPCS), are used to report provider services for the purpose of reimbursement.
Why do providers request that patients sign consent to release information forms? - correct answer
✔✔These forms allow providers to legally to request needed information from other health care
professionals who might have treated the patient. The ability to find out more about the patient's
medical history improves the overall quality of care.
What information is on the encounter form? - correct answer ✔✔The encounter form includes the
patient's name, account number, previous balance, and when the patient needs to come back.
List three ways a medical office can accommodate patients who have vision loss. - correct answer
✔✔Possible answers include having signage in Braille so the patient can find the office; having
documents in Braille and large print; and having modifications built into the computer if the patient is
asked to complete any forms electronically.
Why is health insurance important? - correct answer ✔✔Health insurance is important because it serves
as protections against protection against financial losses due to illness or injury. Insurance provides
financial support for medical needs, hospitalization, medically necessary diagnostic tests and procedures,
and many kinds of preventive services.
True or False: If preauthorization is required but not done, the insurance carrier will not pay for the
medical services provided - correct answer ✔✔True. Before certain procedures can be performed or a
patient hospitalized, many insurance companies require precertification or preauthorization. If this is not
done, insurance claims will be denied.
Who is considered a guarantor? - correct answer ✔✔(REASON) When the patient is the same as the
insured, the patient is also referred to as the guarantor.
(ANSWER) The patient who also is the owner of the primary insurance plan.
What is the birthday rule? - correct answer ✔✔The birthday rule applies to dependent children whose
parents have more than one insurance policy. Under the birthday rule, the health plan of the parent
whose birthday comes first in the calendar year is designated as the primary plan.
What are CPT codes used to describe? - correct answer ✔✔(REASON) Providers use CPT codes for
hospital inpatient and outpatient services.
(ANSWER) Services provided by providers
What is the HIPPA notice of privacy practices form? - correct answer ✔✔Under HIPPA, medical practices
are not allowed to release information unless patients first sign a notice of privacy practices form. This
form explains what's in in a patient's medical record, the patient's health information rights (e.g., request
a restriction on certain uses and disclosures of information, obtain a paper copy of the notice, and
amend, health record requests in writing), and the medical practice's responsibilities to the patient.
, Name three forms that may be found in a patient's medical record. - correct answer ✔✔Examples of
forms found in a patient's medical record include consent to release information, patient financial
responsibility form, and advance directives.
When are regular referrals needed? - correct answer ✔✔(REASON) A regular referral is when the
provider decides that the patient needs to see a specialist.
(ANSWER) A provider decides tat the patient needs to see a specialist.
What is included in a accurate, up-to-date medical record? - correct answer ✔✔(REASON) Medical
records contain all information relevant to patient medical care and insurance.
(ANSWER) All information relevant to patient medical care and insurance.
Name three types of information that falls under the heading "demographics". - correct answer
✔✔Three types of information under the heading "demographics" are name , address, and marital
status.
Why is it important to verify a patient's insurance? - correct answer ✔✔Verifying insurance ensures that
the patient is covered and determines the benefits that will be paid for routine and special procedures
and services. Verification also protects the provider and patient against unexpected medical care costs.
What are the two kinds of coding systems and how are they used? - correct answer ✔✔Clinical coding
systems, such as the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-
CM) and the upcomingICD-10-CM, track a patient's diagnosis and clinical history. Procedural coding
systems, such as Current Procedural Terminology (CPT) codes and the Healthcare Common Procedure
Coding System (HCPCS), are used to report provider services for the purpose of reimbursement.
Why do providers request that patients sign consent to release information forms? - correct answer
✔✔These forms allow providers to legally to request needed information from other health care
professionals who might have treated the patient. The ability to find out more about the patient's
medical history improves the overall quality of care.
What information is on the encounter form? - correct answer ✔✔The encounter form includes the
patient's name, account number, previous balance, and when the patient needs to come back.
