NHA CCMA Exam (2022/2023) with Certified Solutions

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NHA CCMA Exam (2022/2023) with Certified Solutions Advance Beneficiary Notice (ABN) ✔✔A form provided to the patient when the provider believes Medicare will probably not pay for services recei... ved Allowed Amount ✔✔The maximum amount a third-party payer will pay for a particular procedure or service 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 covered losses, typically 80:20 deductible ✔✔specific amount of money a patient must pay out of pocket before the insurance carrier 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 by the provider and the approved fee established by the insurer Medicare ✔✔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 ✔✔U.S. government health insurance plan for all military personnel CHAMPVA ✔✔covers surviving spouses and dependent children of veterans who died as a result of service-related disabilities Medicaid ✔✔provides health insurance to the medically indigent population through a costsharing 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 and hospitals CMS-1500 form ✔✔Standard insurance form used by all government and most commercial insurance payers. - 33 blocks - divided into three section CMS-1500 Section 1 ✔✔Carrier Block: contains the address of the insurance carrier and is located at the top 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 Supine Position ✔✔ Dorsal Recumbent Position ✔✔ Sims' Position ✔✔ Knee-elbow position ✔✔ Fowler's Position ✔✔ Lithotomy Position ✔✔ 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 marro [Show More]

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