CMAA Certified Medical Administrative Assistant MCQ 2 — Questions and Answers
Question 1: How should a prescription refill request received by phone be handled?
- Authorize the refill directly
- Document completely, forward to clinical staff for authorization, follow up with patient (Correct answer)
- Tell patient to call the pharmacy
- Refuse to take the message
Correct answer: Document completely, forward to clinical staff for authorization, follow up with patient
Document all details, forward to the appropriate clinical staff for review, and follow up with the patient on the decision.
Gather: patient name/DOB, medication/dosage, pharmacy info, refills requested, any concerns or side effects, prescribing provider. Document in EHR, route to clinical staff. Never authorize or deny refills. After provider review, notify patient of decision or confirm pharmacy receipt.
Question 2: Why is maintaining accurate patient demographic information important?
- Only for marketing
- Essential for proper billing, claims processing, communication, and care coordination (Correct answer)
- Only matters at first visit
- Only name and phone matter
Correct answer: Essential for proper billing, claims processing, communication, and care coordination
Accurate demographics are critical for successful claims, effective communication, patient identification, and coordinated care.
Inaccurate demographics cause: claim rejections, communication failures, patient ID errors (dangerous with similar names), billing problems, referral complications, and reporting issues. Verify at every visit, update immediately, use multiple identifiers for confirmation.
Question 3: Which regulation requires emergency medical screening for all ER patients?
- HIPAA
- EMTALA (Correct answer)
- OSHA
- ADA
Correct answer: EMTALA
EMTALA requires Medicare-participating hospitals to provide medical screening and stabilization to all ER patients regardless of payment ability.
EMTALA ensures: medical screening examination for all ER patients, stabilizing treatment for emergency conditions, no transfer until stabilized unless specific conditions met, no delays for insurance verification. Violations: $50,000+ fines, Medicare termination. CMAAs in ERs must understand this.
Question 4: What is the primary purpose of a compliance officer?
- Manage the office budget
- Oversee adherence to healthcare regulations and implement corrective measures (Correct answer)
- Hire and fire staff
- Handle all patient complaints
Correct answer: Oversee adherence to healthcare regulations and implement corrective measures
The compliance officer develops and manages the compliance program, ensures regulatory adherence, conducts audits, and implements corrective actions.
Responsibilities: develop/maintain compliance program, serve as compliance contact, conduct internal audits, manage reporting mechanisms, investigate violations, coordinate with legal counsel, stay current with regulations, and provide training. CMAAs should know their compliance officer and how to report concerns.
Question 5: A claim is denied for 'lack of medical necessity.' What should the CMAA do?
- Accept denial and bill the patient
- Review denial, gather supporting documentation, and file an appeal (Correct answer)
- Resubmit the same claim unchanged
- Tell patient the practice can't help
Correct answer: Review denial, gather supporting documentation, and file an appeal
Review the denial reason, work with clinical team for supporting documentation, and file a formal appeal within the payer's deadline.
Review the denial letter for specific reasons and deadline. Consult clinical team for additional documentation. Gather clinical notes, test results, and peer-reviewed literature. Write clear appeal letter citing policy provisions. Include physician letter of medical necessity. Track appeal status. Many initially denied claims are overturned.
Question 6: What is the purpose of daily payment reconciliation?
- Count patients seen
- Verify all payments match system records, ensuring accuracy and detecting discrepancies (Correct answer)
- Calculate physician earnings
- Determine if more receipt paper is needed
Correct answer: Verify all payments match system records, ensuring accuracy and detecting discrepancies
Daily reconciliation compares actual payments (cash, checks, cards) against system records to ensure accuracy and identify discrepancies.
Process: run end-of-day report, count cash, total checks, run credit card batch report, compare each category against system totals, investigate discrepancies, prepare bank deposit, and sign off on reconciliation. Common discrepancy causes: data entry errors, wrong account postings, missed postings. Have another staff member verify cash counts.
CMAA Certified Medical Administrative Assistant MCQ 2
How should a prescription refill request received by phone be handled?