CCMA NHA Module 1 questions with verified answers
Accountable Care Organizations (ACOs) Ans✓✓✓ these groups of physicians,
hospitals, and other health care providers come together voluntarily to provide
coordinated high-quality care to their Medicare patients, when an ACO succeeds
in delivering high-quality care and spending health care dollars wisely, it will share
the savings it achieves for the Medicare program
Advanced beneficiary notice (ABN) Ans✓✓✓ form provided to the patient when
the provider believes Medicare will probably not pay for services received
Allergists Ans✓✓✓ evaluate disorders and diseases of the immune system,
including adverse reactions to medications and food, anaphylaxis, problems
related to autoimmune disease, and asthma
Allopathic Ans✓✓✓ homeopathic medicine, categorized by an effort to
counteract the symptoms of disease by administration of treatments that
produce the effects opposite to the symptoms
Allowed amount Ans✓✓✓ the maximum amount a third party payer will pay for
a particular procedure
Anesthesiologists Ans✓✓✓ manage pain or use sedation during surgical
procedures
Capitation (partial of full) Ans✓✓✓ in this payment model patients are assigned a
per-member, per-month payment based on their age, race, sex, lifestyle, medical
history, and benefit design, payment rates are tied to expected usage regardless
of how often the patient visits, like bundled payment models providers have an
incentive to help patients avoid high-cost procedure and tests to maximize their
, compensation, under partial or blended capitation models only specific types or
categories of services are paid on a basis of capitation
Cardiologists Ans✓✓✓ specialize in diagnosing and treating disease and
conditions of the heart and blood vessels
CHAMPVA Ans✓✓✓ covers surviving spouses and dependent children of
veterans who died as a result of service-related disabilities
CMS-1500 Form Section 1: Carrier Block Ans✓✓✓ contains the address of the
insurance carrier and is located at the top of the form
CMS-1500 Form Section 2: Insured Section Ans✓✓✓ contains information about
the patient or insured (if other than the patient) includes boxes 1 through 13
CMS-1500 Form Section 3: Supplier Section Ans✓✓✓ contains information about
the physician or supplier, includes boxes 14 through 33
Coinsurance Ans✓✓✓ a policy provision frequently found in medical insurance
whereby the policyholder and the insurance company share the cost of covered
losses in a specified ratio, such as 80:20
Copayment Ans✓✓✓ an amount of money that is paid at the time of medical
service
Deductible Ans✓✓✓ a specific amount of money a patient must pay out of
pocket before the insurance carrier begins paying
Accountable Care Organizations (ACOs) Ans✓✓✓ these groups of physicians,
hospitals, and other health care providers come together voluntarily to provide
coordinated high-quality care to their Medicare patients, when an ACO succeeds
in delivering high-quality care and spending health care dollars wisely, it will share
the savings it achieves for the Medicare program
Advanced beneficiary notice (ABN) Ans✓✓✓ form provided to the patient when
the provider believes Medicare will probably not pay for services received
Allergists Ans✓✓✓ evaluate disorders and diseases of the immune system,
including adverse reactions to medications and food, anaphylaxis, problems
related to autoimmune disease, and asthma
Allopathic Ans✓✓✓ homeopathic medicine, categorized by an effort to
counteract the symptoms of disease by administration of treatments that
produce the effects opposite to the symptoms
Allowed amount Ans✓✓✓ the maximum amount a third party payer will pay for
a particular procedure
Anesthesiologists Ans✓✓✓ manage pain or use sedation during surgical
procedures
Capitation (partial of full) Ans✓✓✓ in this payment model patients are assigned a
per-member, per-month payment based on their age, race, sex, lifestyle, medical
history, and benefit design, payment rates are tied to expected usage regardless
of how often the patient visits, like bundled payment models providers have an
incentive to help patients avoid high-cost procedure and tests to maximize their
, compensation, under partial or blended capitation models only specific types or
categories of services are paid on a basis of capitation
Cardiologists Ans✓✓✓ specialize in diagnosing and treating disease and
conditions of the heart and blood vessels
CHAMPVA Ans✓✓✓ covers surviving spouses and dependent children of
veterans who died as a result of service-related disabilities
CMS-1500 Form Section 1: Carrier Block Ans✓✓✓ contains the address of the
insurance carrier and is located at the top of the form
CMS-1500 Form Section 2: Insured Section Ans✓✓✓ contains information about
the patient or insured (if other than the patient) includes boxes 1 through 13
CMS-1500 Form Section 3: Supplier Section Ans✓✓✓ contains information about
the physician or supplier, includes boxes 14 through 33
Coinsurance Ans✓✓✓ a policy provision frequently found in medical insurance
whereby the policyholder and the insurance company share the cost of covered
losses in a specified ratio, such as 80:20
Copayment Ans✓✓✓ an amount of money that is paid at the time of medical
service
Deductible Ans✓✓✓ a specific amount of money a patient must pay out of
pocket before the insurance carrier begins paying
