HOSMERIT
NHA CCMA EXAM QUESTIONS & VERIFIED
ANSWERS | LATEST | GRADED A+
Advance Beneficiary Notice (ABN)
➹➹➹: A form provided to the patient when the provider believes Medicare will probablynot pay
for services received
Allowed Amount
➹➹➹: The maximum amount a third-party payer will pay for a particular procedure orservice
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 coveredlosses,
typically 80:20
deductible
➹➹➹: specific amount of money a patient must pay out of pocket before the insurancecarrier
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 bythe
provider and the approved fee established by the insurer
Medicare
➹➹➹: A federal program of health insurance for persons 65 years of age and older byPart 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 aresult of
service-related disabilities
Medicaid
➹➹➹: 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 andhospitals
CMS-1500 form
➹➹➹: Standard insurance form used by all government and most commercialinsurance payers.
- 33 blocks
- divided into three section
CMS-1500 Section 1
➹➹➹: Carrier Block: contains the address of the insurance carrier and is located at thetop of the
form
CMS-1500 Section 2
➹➹➹: Patient/insured section: contains information about the patient or insured;includes boxes
1-13
CMS-1500 Section 3
➹➹➹: Physician/Supplier Section: contains information about the physician or supplier:boxes
14-33
, Epidural Injection
➹➹➹: epidural space of the spine
Intra-arterial Injection
➹➹➹: injection into an artery (to break up clots)
Intra-articular Injection
➹➹➹: injection into joint space
Intradermal Injection
➹➹➹: Skin of the upper chest, forearms, upper pack. 5-15º angle
intramuscular injection
➹➹➹: deltoid, vastus lateralis, ventrogluteal muscles
Intraosseous Injection
➹➹➹: Bone marrow
Intraperitoneal Injection
➹➹➹: within the peritoneal cavity
Intrapleural Injection
➹➹➹: pleural space (lungs)
Intrathecal Injection
➹➹➹: Subarachnoid space (brain)
NHA CCMA EXAM QUESTIONS & VERIFIED
ANSWERS | LATEST | GRADED A+
Advance Beneficiary Notice (ABN)
➹➹➹: A form provided to the patient when the provider believes Medicare will probablynot pay
for services received
Allowed Amount
➹➹➹: The maximum amount a third-party payer will pay for a particular procedure orservice
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 coveredlosses,
typically 80:20
deductible
➹➹➹: specific amount of money a patient must pay out of pocket before the insurancecarrier
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 bythe
provider and the approved fee established by the insurer
Medicare
➹➹➹: A federal program of health insurance for persons 65 years of age and older byPart 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 aresult of
service-related disabilities
Medicaid
➹➹➹: 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 andhospitals
CMS-1500 form
➹➹➹: Standard insurance form used by all government and most commercialinsurance payers.
- 33 blocks
- divided into three section
CMS-1500 Section 1
➹➹➹: Carrier Block: contains the address of the insurance carrier and is located at thetop of the
form
CMS-1500 Section 2
➹➹➹: Patient/insured section: contains information about the patient or insured;includes boxes
1-13
CMS-1500 Section 3
➹➹➹: Physician/Supplier Section: contains information about the physician or supplier:boxes
14-33
, Epidural Injection
➹➹➹: epidural space of the spine
Intra-arterial Injection
➹➹➹: injection into an artery (to break up clots)
Intra-articular Injection
➹➹➹: injection into joint space
Intradermal Injection
➹➹➹: Skin of the upper chest, forearms, upper pack. 5-15º angle
intramuscular injection
➹➹➹: deltoid, vastus lateralis, ventrogluteal muscles
Intraosseous Injection
➹➹➹: Bone marrow
Intraperitoneal Injection
➹➹➹: within the peritoneal cavity
Intrapleural Injection
➹➹➹: pleural space (lungs)
Intrathecal Injection
➹➹➹: Subarachnoid space (brain)
