CMAA - Certified Medical Administrative Assistant Insurance Verification and Processing Questions and Answers

Question 1

A new patient provides their insurance card at check-in. Which of the following is the MOST critical first step for the CMAA to take to prevent claim denials?

Accepted Answer

Verify insurance eligibility and benefits.

Answer

Collect the copayment listed on the card.

Answer

Scan a copy of the card for the patient's record.

Answer

Ask the patient to sign a financial responsibility form.

Question 2

A patient is covered by two insurance plans: one through their own employer and another as a dependent on their spouse's plan. The process of determining which plan is primary and which is secondary is known as:

Accepted Answer

Coordination of Benefits (COB)

Answer

Preauthorization

Answer

Assignment of Benefits

Answer

Remittance Advice

Question 3

A patient's insurance plan requires them to pay a fixed amount of $30 for each office visit. This type of payment is called a(n):

Accepted Answer

Copayment

Answer

Deductible

Answer

Coinsurance

Answer

Premium

Question 4

A CMAA is reviewing a document from a payer that details the payment, adjustments, and any denials for a batch of recently submitted claims. This document is sent to the provider's office and is called a(n):

Accepted Answer

Remittance Advice (RA)

Answer

Explanation of Benefits (EOB)

Answer

Preauthorization Form

Answer

Encounter Form

Question 5

A provider recommends a specific surgical procedure for a patient. The patient's insurance policy requires the medical office to obtain approval from the insurer before the procedure can be performed to ensure it will be covered. This process is called:

Accepted Answer

Preauthorization

Answer

Eligibility Verification

Answer

Coordination of Benefits

Answer

Claims Adjudication

Question 6

Which of the following describes the patient's financial responsibility that is a percentage of the allowed amount for a service, which they must pay after their deductible has been met?

Accepted Answer

Coinsurance

Answer

Copayment

Answer

Premium

Answer

Allowed Amount