CMA Administrative Office Procedures 3 — Questions and Answers
Question 1: Which federal law mandates that employees be given up to 12 weeks of unpaid, job-protected leave for qualifying family or medical reasons?
- ADA
- OSHA
- FMLA (Correct answer)
- COBRA
Correct answer: FMLA
The Family and Medical Leave Act (FMLA) provides eligible employees up to 12 weeks of unpaid protected leave per year.
Question 2: In the context of medical billing, 'coordination of benefits' means:
- Submitting the same claim to multiple insurers simultaneously
- Determining which insurance plan pays first when a patient has multiple coverages (Correct answer)
- Negotiating a reduced fee with the insurance company
- Transferring patient benefits from one plan to another
Correct answer: Determining which insurance plan pays first when a patient has multiple coverages
Coordination of benefits establishes the order in which multiple insurance plans pay to prevent duplicate payment.
Question 3: A medical assistant receives a call from someone identifying themselves as a nurse from a specialist's office requesting lab results. The BEST action is to:
- Provide the results immediately since it is another healthcare provider
- Ask the caller to hold while you get the physician
- Verify the caller's identity and obtain patient authorization before releasing information (Correct answer)
- Refuse to release any information over the phone
Correct answer: Verify the caller's identity and obtain patient authorization before releasing information
HIPAA requires verification of the requestor's identity and appropriate patient authorization before disclosing PHI to any third party.
Question 4: The 'tickler file' in a medical office is used to:
- Track overdue patient accounts
- Flag reminders for future follow-up tasks on specific dates (Correct answer)
- Store frequently used phone numbers
- Log incoming faxes
Correct answer: Flag reminders for future follow-up tasks on specific dates
A tickler file is a chronological reminder system that prompts staff to take action on specific items on or by a certain date.
Question 5: Which form must patients sign before the medical office can share their health information with their health insurance company for payment purposes?
- Notice of Privacy Practices acknowledgment (Correct answer)
- HIPAA authorization form
- Assignment of benefits form
- Release of medical records form
Correct answer: Notice of Privacy Practices acknowledgment
Patients sign the Notice of Privacy Practices acknowledgment, which covers routine disclosures for treatment, payment, and operations without a separate authorization.
Question 6: An 'established patient' in a medical office is defined as one who has:
- Been seen in the practice within the last 5 years
- Been seen by any physician in the same specialty group within the last 3 years (Correct answer)
- Signed a patient registration form
- Had at least two previous visits to the practice
Correct answer: Been seen by any physician in the same specialty group within the last 3 years
CMS defines an established patient as one who has received professional services from the physician or a physician of the same specialty in the same group within the past 3 years.
Question 7: Which scheduling technique is BEST suited for a practice with frequent no-shows, because it deliberately books more patients than available slots?
- Wave scheduling (Correct answer)
- Stream scheduling
- Double-booking
- Open access scheduling
Correct answer: Wave scheduling
Wave scheduling books multiple patients at the top of each hour, expecting that some will arrive late or not show, leveling patient flow.
CMA Administrative Office Procedures 3
Which federal law mandates that employees be given up to 12 weeks of unpaid, job-protected leave for qualifying family or medical reasons?