CMAA Comprehensive Review Flashcards
6 cards from real CMAA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CMAA Comprehensive Review flashcards as text
Unique usernames and strong passwords in an EHR are which HIPAA Security Rule safeguard?
Answer: Technical
User identification and passwords are technical safeguards involving technology-based access controls.
How does workers' compensation billing differ from standard insurance?
Answer: Billed to employer's workers' comp carrier; patient has no copay or deductible
Workers' comp claims go to the employer's carrier, not patient insurance. The employee typically has zero out-of-pocket costs.
What did MACRA create in healthcare?
Answer: The Quality Payment Program linking reimbursement to quality metrics
MACRA created the Quality Payment Program (QPP) tying Medicare reimbursement to quality and value measures.
What should be included in a specialist referral?
Answer: Demographics, insurance, clinical reason, relevant history, diagnostic results, and referring provider info
A complete referral includes demographics, insurance/authorization, referral reason, relevant history, test results, and provider contacts.
What is the difference between a deductible and a copayment?
Answer: Deductible is annual amount before insurance covers costs; copayment is fixed per-visit fee
A deductible is the annual threshold before insurance pays; a copayment is a fixed fee at each visit regardless of deductible.
A data entry error is found in a billing record after claim submission. What should the CMAA do?
Answer: Contact the payer/clearinghouse to correct or void, submit corrected claim, document the error
Proactively contact the payer or clearinghouse to void or correct the claim, submit an accurate corrected claim, and document everything.