CMAA Patient Intake and Registration 5 — Questions and Answers
Question 1: A returning patient states they have a new secondary insurance plan. Which step should be completed FIRST?
- Bill the secondary insurer immediately
- Collect the new insurance card, verify eligibility, and update the account before services are rendered (Correct answer)
- Notify the patient that secondary insurance cannot be added mid-year
- Contact the primary insurer to cancel the existing policy
Correct answer: Collect the new insurance card, verify eligibility, and update the account before services are rendered
Eligibility must be verified and the account updated before the visit to ensure correct billing sequence and avoid claim denials.
Question 2: Which of the following best describes a 'guarantor' on a patient registration form?
- The physician responsible for the patient's care
- The person financially responsible for the patient's account (Correct answer)
- The insurance company covering the patient
- The referring provider who sent the patient
Correct answer: The person financially responsible for the patient's account
The guarantor is the individual legally responsible for paying the account balance, which may differ from the patient (e.g., a parent for a minor).
Question 3: When a patient presents with a workers' compensation injury, which information is ESSENTIAL to collect at registration?
- Patient's personal health insurance card only
- Employer name, date of injury, claim number, and workers' comp carrier information (Correct answer)
- Next of kin contact details
- Patient's preferred pharmacy
Correct answer: Employer name, date of injury, claim number, and workers' comp carrier information
Workers' compensation claims require specific employer and claim details because billing goes to the WC carrier, not the patient's personal health insurance.
Question 4: What is the purpose of obtaining a patient's referring provider information during registration?
- To send the patient's bill to the referring provider
- To ensure proper documentation for insurance referral requirements and for care coordination (Correct answer)
- To verify that the referring provider accepts the same insurance plan
- To determine the patient's primary diagnosis
Correct answer: To ensure proper documentation for insurance referral requirements and for care coordination
Many insurance plans require a referral authorization from the primary care provider; capturing this information ensures the visit is reimbursable and supports continuity of care.
Question 5: A patient's photo ID does not match the name on their insurance card. What should the MAA do?
- Accept the insurance card and proceed without question
- Politely ask the patient to clarify the discrepancy and document the explanation before proceeding (Correct answer)
- Refuse service immediately and call security
- Enter the name on the ID and ignore the insurance card name
Correct answer: Politely ask the patient to clarify the discrepancy and document the explanation before proceeding
Discrepancies between ID and insurance information must be investigated and documented to prevent identity fraud and ensure accurate billing.
Question 6: Under the Affordable Care Act, how long can a dependent child remain on a parent's health insurance plan?
- Until age 18
- Until age 21
- Until age 26 (Correct answer)
- Until age 25 or marriage, whichever comes first
Correct answer: Until age 26
The ACA requires health plans that cover dependents to allow children to remain on a parent's plan until age 26, regardless of student or marital status.
Question 7: A patient refuses to provide their Social Security Number during registration. What is the appropriate response?
- Refuse to register the patient until the SSN is provided
- Explain that it is requested but not always mandatory, and proceed using other identifiers such as date of birth and member ID (Correct answer)
- Enter a placeholder number in the system
- Report the patient to the billing department for non-compliance
Correct answer: Explain that it is requested but not always mandatory, and proceed using other identifiers such as date of birth and member ID
While SSN helps with insurance verification and collections, patients generally cannot be denied care for refusing; alternative identifiers can be used to complete registration.
CMAA Patient Intake and Registration 5
A returning patient states they have a new secondary insurance plan.
Which step should be completed FIRST?