*NURSING > QUESTIONS & ANSWERS > CCMA NHA. Top Exam Questions with accurate answers, graded A+ (All)

CCMA NHA. Top Exam Questions with accurate answers, graded A+

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CCMA NHA. Top Exam Questions with accurate answers, graded A+ What is within the scope of practice for a CCMA ? - ✔✔-1. Educating patients on how to take their medication 2. Health promotion... of the patient. 3. Performing an EKG. 4. Taking patients vitals. 5. Performing urinalysis. 6. Performing a throat culture. 7. Patient education. What is outside the scope of practice ? - ✔✔-1. Diagnosing patients. 2. Administering narcotics. 3. Interpreting laboratory results. 4. Pathogenic identification. 5. Performing an Arterial Blood Gas (ABG) What is assault ? - ✔✔-Open threat of bodily harm against another person. What is battery ? - ✔✔-An action that causes bodily harm. How do you define fraud ? - ✔✔-Deception with the intent to deprive another person of his or her own rights. What is invasion of privacy ? - ✔✔-Intruding on a patients private affairs, or disclosure of private information. Example: Entering a patients room without knocking or having permission. Malpractice ? - ✔✔-The negligent delivery of professional services. Negligence ? - ✔✔-The failure to do something that a reasonably prudent individual would do under similar circumstances. Spousal abuse/ Intimate partner abuse ? - ✔✔-Provides a list of organizations within the local community that can assist in the situation. What should you do if you suspect child abuse ? - ✔✔-Report suspected child abuse to the provider. Tort ? - ✔✔-A civil wrong committed against a person or property. (fraud) Chain of custody ? - ✔✔-In legal context, refers to the chronological documentation showing the paper trail, custody, control, transfer, analysis, and disposition of physical or electronic evidence. Sample evidence must be sealed in front of patient. (drug screen) What is the purpose of the CLIA ? - ✔✔-Clinical laboratory Improvement Amendment sets quality standards and issues certifications for human laboratories. Health Insurance Portability and Accountability Act (HIPPA) - ✔✔-Then right to inspect, review, and to receive a copy of your medical records and billing records that are held by health plans and healthcare providers covered by the privacy rule. What are the two main purposes of HIPPA ? - ✔✔-1. To provide continuous health insurance coverage for workers who lose or change their job. 2.To reduce the administrative burdens and cost of healthcare by standardizing the electronic transmission of administrative and financial transactions and protects the patients personal medical information and confidentiality. A CCMA cannot disclose what information ? - ✔✔-A Patients information unless authorized. Discussing a patients medical information is breaking what ? - ✔✔-HIPPA guidelines Even if you are related to the patient you are required to have what to obtain medical information ? - ✔✔-Consent of the patient The Joint Commission is responsible for what ? - ✔✔-Regulates that identifying patients is crucial to improving patient safety. Occupational Safety and Health Administration (OSHA) - ✔✔-1. Federal agency that oversees and regulates safety in the workplace. 2. Training provided to employee at no cost. Quality Control (QC) promotes what ? - ✔✔-Accurate test results What is the most important step in ensuring patient safety ? - ✔✔-Is proper identification Always ask for what two forms of identification to ID a patient ? - ✔✔-FULL NAME DATE OF BIRTH Never confirm a patients name and date of birth how ? - ✔✔-By speaking their name and date of birth to them. If they are not paying attention they may say yes when they didn't hear you. What is implied consent ? - ✔✔-Extending an arm for phlebotomy Removing clothes for a medical procedure or examination. What is informed consent ? - ✔✔-Informing the patient of the risk, possible outcomes, and alternative therapies. What is written consent ? - ✔✔-Must have a patients signature to perform procedure. Patients bill of rights ? - ✔✔-A list of guarantees for those receiving medical care. What are some of the rights to the patient covered under patients bill of rights ? - ✔✔-1. Patients have the right to a copy of their medical records. 2.Guarantees fair treatment. 3. Autonomy over medical decisions and many more rights. POMR Should always be filled in what order ? (Problem Oriented Medical Record) - ✔✔-Should always be filled out in chronological order. Patients have a right to view their medical records at any time. The information in the medical record belongs to who ? - ✔✔-The medical record belongs to the patient, however the place where the information is housed belongs to the author. What is a CMS-1500 form used for ? - ✔✔-Basic standard claim form used by healthcare professionals to request reimbursement for services provided to patients. Encounter form or Superbill is used for what ? - ✔✔-An itemized form of services submitted to insurance carriers for reimbursement of rendered services. A CCMA would also use this form to check out patients. Release of information form allows what ? - ✔✔-Allows a patient access to his own medical records and allows the patient control over to whom the medical records are released. Preferred provider organization (PPO) - ✔✔-Managed care organization of providers, hospitals, and other healthcare providers who have agreed with an insurer or a third party administrator to provide health care at a reduced rates to the insurers administrators clients. Medicaid provides healthcare coverage for whom ? - ✔✔-Provides health insurance for the medically needy. Medicare is for ? - ✔✔-Federal insurance plan that generally covers those over the age of 65 and is considered an entitlement because most have paid into the system through there employer. Tricare is ? - ✔✔-Healthcare for military personal and their dependents to receive care form a civilian provider at the expense of the federal government. What is the purpose of Workers Compensation ? - ✔✔-Wage replacement and medical benefits for those injured on the job. Advance Beneficiary Notice (ABN) - ✔✔-Waiver of liability, is a notice a provider should give you before you receive a service if, based on Medicare coverage rules, your provider has reason to believe Medicare will not pay for the service. The bill will be the patients responsibility. What is coinsurance ? - ✔✔-An amount a policy holder is responsible for according to their insurance policy. The policy holder must meet a specific amount before the insurance company will pay their portion. What is a copay ? - ✔✔-A specific amount of money based on the patients insurance policy that must be paid at time of service. deductible ? - ✔✔-Specific amount of money a patient must pay out-of-pocket before the insurance carrier begins paying for service in a calendar year. Explanation of benefits (EOB) ? - ✔✔-A statement detailing what services were paid, denied, or reduced in payment by the patients insurance company. Preauthorization ? - ✔✔-A decision by your health insurer or plan that that a health care service, treatment, plan, perscription drug, or durable medical equipment is medically necessary. Precertification ? - ✔✔-The process of obtaining eligibility, certification, or authorization and collecting information from the health plan prior to impatient admissions and selected ambulatory care Referral ? - ✔✔-The process of directing or redirecting to a medical specialist or agency for definitive treatment. (Some insurance companies require this) Verification of eligibility ? - ✔✔-Before care is provided, it is important to verify that a patients eligibility for service is active. CPT ? - ✔✔-Current Procedural Terminology ICD ? - ✔✔-International classification of disease Each diagnostic and procedural code allows for submission of services for reimbursement from insurance companies and to provide statistical data for research. There are how many characters used in ICD ? - ✔✔-Three to Seven First character is used for what ? - ✔✔-Main term when searching in alphabetical order Second and third characters ? - ✔✔-Numeric codes Fourth, Fifth, six, or seventh ? - ✔✔-Being alphabetic or numeric What is a modifier ? - ✔✔-Indicates one procedure was used multiple times on a patient. What is Advance Booking ? - ✔✔-Making an appoint for a patient in advance. What is Clustering ? - ✔✔-Seeing patients on the same day at the same time. Double Booking ? - ✔✔-Two patients are given the same appointment time. What should you do if the provider is LATE [Show More]

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