CCMA - ADMINISTRATIVE ASSISTING
2025/2026 EXAM WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
ANSWERS |CURRENTLY TESTING
QUESTIONS AND SOLUTIONS|ALREADY
GRADED A+|NEWEST|BRAND NEW
VERSION!!|GUARANTEED PASS
A medical assistant is determining the amount a patient will be required to pay for a scheduled
procedure that has an allowable amount of $200. The patient has a 90/10 coinsurance and has
met his deductible. What is the total amount the patient will pay the provider for the service?
$20
Problem-focused examination
single body area or system mentioned in CC
Expanded problem-focused examination
body area or system in CC as well as related body areas or systems
Detailed examination
include CC, related body areas or systems as well as present and past medical history, family
history, social history
Comprehensive examination
complete examination of multiple body systems related and unrelated to the CC, family history,
social history, and detailed medical history
What to do if a patient contacts you saying they got a bill for services they did not receive?
Must review the encounter form to see if this patient was seen and what services they received
Encounter form = accounts for changes, payments, balances for each patient
1|Page
,Are not required to pay until services are confirmed, but must confirm if charge was accurate
before writing them off
Does not matter if there are other charges
Birthday rule
primary insurance policy is determined by which parent has the earliest birthday month
Medicare claim denial
Fee schedule must follow usual, customary, reasonable requirements for repayment
If charges exceed usual, customary, and reasonable fees? Revisit the charges in question and
adjust pt's account to reflect no unpaid charges and write off the balance
Scheduling an outpatient appointment
MUST always begin with obtaining oral or written order from provider before getting
authorization, calling outpatient facility, contacting patient for availability
Usual fee
fee most commonly charged by provider for given service
Reasonable fee
fee for services or procedures that requires extra time and effort for the provider due to level of
complexity
Customary fee
range of fees charged by providers who have similar training and experience and practice in
same geographical area
Capitation
fixed amt money paid to provider by third party payer per individual enrollee for established
period
Encounter form (superbill)
contains info about any and all services provided by clinical staff, additional actions
(referrals/follow-up appts)
Can you disclose estimated costs of a procedure to a patient?
2|Page
, Yes
What notes can a patient request?
List of medications with diagnoses
Summary of psychotherapy notes
Copies of medical records or images (i.e. of x-rays)
NEVER information for legal proceedings
Against Medical Advice (AMA)
when a noncompliant patient leaves a hospital without physician's permission against advice
from the physician
What piece of information is required for referrals?
Diagnosis
Phantom providers
file false claims from offices that don't actually exist. It's all an elaborate fraud scheme designed
to get insurance companies to pay out on these false claims.
Phantom billing is a form of
Fraud
Problem-oriented medical record (POMR)
Documentation system organized according to the person's specific health problems
Problem list = social, demographic, medical, surgical concerns
Database = medical history, diagnostic and lab results, ROS, CC, present illness
Progress notes = for every problem; enter chronologically, include CC/treatment/response to
treatment
Diagnostic and treatment plan = for each condition and lab/diagnostic test prescriptions
Category I code
special circumstances → use modifier in conjunction to provide further clarification
Category II code
tracks provider performance measures
Category III code
3|Page
2025/2026 EXAM WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
ANSWERS |CURRENTLY TESTING
QUESTIONS AND SOLUTIONS|ALREADY
GRADED A+|NEWEST|BRAND NEW
VERSION!!|GUARANTEED PASS
A medical assistant is determining the amount a patient will be required to pay for a scheduled
procedure that has an allowable amount of $200. The patient has a 90/10 coinsurance and has
met his deductible. What is the total amount the patient will pay the provider for the service?
$20
Problem-focused examination
single body area or system mentioned in CC
Expanded problem-focused examination
body area or system in CC as well as related body areas or systems
Detailed examination
include CC, related body areas or systems as well as present and past medical history, family
history, social history
Comprehensive examination
complete examination of multiple body systems related and unrelated to the CC, family history,
social history, and detailed medical history
What to do if a patient contacts you saying they got a bill for services they did not receive?
Must review the encounter form to see if this patient was seen and what services they received
Encounter form = accounts for changes, payments, balances for each patient
1|Page
,Are not required to pay until services are confirmed, but must confirm if charge was accurate
before writing them off
Does not matter if there are other charges
Birthday rule
primary insurance policy is determined by which parent has the earliest birthday month
Medicare claim denial
Fee schedule must follow usual, customary, reasonable requirements for repayment
If charges exceed usual, customary, and reasonable fees? Revisit the charges in question and
adjust pt's account to reflect no unpaid charges and write off the balance
Scheduling an outpatient appointment
MUST always begin with obtaining oral or written order from provider before getting
authorization, calling outpatient facility, contacting patient for availability
Usual fee
fee most commonly charged by provider for given service
Reasonable fee
fee for services or procedures that requires extra time and effort for the provider due to level of
complexity
Customary fee
range of fees charged by providers who have similar training and experience and practice in
same geographical area
Capitation
fixed amt money paid to provider by third party payer per individual enrollee for established
period
Encounter form (superbill)
contains info about any and all services provided by clinical staff, additional actions
(referrals/follow-up appts)
Can you disclose estimated costs of a procedure to a patient?
2|Page
, Yes
What notes can a patient request?
List of medications with diagnoses
Summary of psychotherapy notes
Copies of medical records or images (i.e. of x-rays)
NEVER information for legal proceedings
Against Medical Advice (AMA)
when a noncompliant patient leaves a hospital without physician's permission against advice
from the physician
What piece of information is required for referrals?
Diagnosis
Phantom providers
file false claims from offices that don't actually exist. It's all an elaborate fraud scheme designed
to get insurance companies to pay out on these false claims.
Phantom billing is a form of
Fraud
Problem-oriented medical record (POMR)
Documentation system organized according to the person's specific health problems
Problem list = social, demographic, medical, surgical concerns
Database = medical history, diagnostic and lab results, ROS, CC, present illness
Progress notes = for every problem; enter chronologically, include CC/treatment/response to
treatment
Diagnostic and treatment plan = for each condition and lab/diagnostic test prescriptions
Category I code
special circumstances → use modifier in conjunction to provide further clarification
Category II code
tracks provider performance measures
Category III code
3|Page
