CCMA Administrative Duties 4 — Questions and Answers
Question 1: A patient calls requesting their medical records be sent to a specialist. What is the FIRST step the medical assistant should take?
- Send the records immediately to expedite care
- Obtain a signed authorization for release of information from the patient (Correct answer)
- Verify the specialist's fax number before sending
- Check with the physician before releasing any records
Correct answer: Obtain a signed authorization for release of information from the patient
HIPAA requires a signed patient authorization before releasing medical records to any third party, including other providers.
Question 2: Which billing form is used to submit claims to Medicare for outpatient and professional services?
- UB-04
- CMS-1500 (Correct answer)
- ADA Dental Claim Form
- HCFA-1450
Correct answer: CMS-1500
The CMS-1500 form is the standard paper claim form used by non-institutional providers to bill Medicare, Medicaid, and most private payers.
Question 3: A patient's insurance requires prior authorization for an MRI. The physician orders the MRI urgently. What should the medical assistant do?
- Schedule the MRI and hope the insurer approves retroactively
- Contact the insurance company to request an expedited prior authorization (Correct answer)
- Advise the patient to pay out-of-pocket and seek reimbursement later
- Cancel the MRI order until standard authorization is obtained
Correct answer: Contact the insurance company to request an expedited prior authorization
When urgent care is needed, the MA should contact the insurer to request expedited (urgent) prior authorization rather than delaying or skipping the process.
Question 4: What does the term 'accounts receivable' refer to in a medical practice?
- Money owed by the practice to vendors and suppliers
- Money owed to the practice for services already rendered (Correct answer)
- The total payroll expenses for the billing department
- Payments received from insurance companies in the current month
Correct answer: Money owed to the practice for services already rendered
Accounts receivable represents the total amount of money owed to the practice by patients and insurance companies for services already provided.
Question 5: A patient arrives 25 minutes late for a 30-minute appointment. What is the best action for the medical assistant to take?
- Automatically reschedule the patient without consulting the provider
- Check with the provider to determine if the patient can still be seen (Correct answer)
- Tell the patient they have forfeited their appointment and must pay a no-show fee
- Seat the patient and add them to the end of the schedule without notifying the provider
Correct answer: Check with the provider to determine if the patient can still be seen
The provider should decide whether a late patient can still be seen given remaining appointment time and the day's schedule.
Question 6: Which scheduling method books several patients at the same appointment time with the expectation that not all will arrive?
- Double-booking
- Wave scheduling (Correct answer)
- Cluster scheduling
- Open scheduling
Correct answer: Wave scheduling
Wave scheduling books multiple patients in the same time slot (e.g., three patients at 9:00 AM) to maintain a steady patient flow throughout the hour.
Question 7: When entering a new patient's demographic information, which detail is MOST critical to verify for accurate insurance billing?
- Patient's preferred pharmacy
- Patient's exact name and date of birth as listed on their insurance card (Correct answer)
- Patient's emergency contact relationship
- Patient's preferred appointment time
Correct answer: Patient's exact name and date of birth as listed on their insurance card
The patient's name and date of birth must exactly match what the insurance company has on file, or claims will be rejected or denied.
CCMA Administrative Duties 4
A patient calls requesting their medical records be sent to a specialist.
What is the FIRST step the medical assistant should take?