NCMA CCMA EXAM 4 FINAL PAPER 2026
COMPLETE QUESTIONS AND ANSWERS
◉ EMR. Answer: electronic medical record
◉ suffix. Answer: word ending
◉ prefix. Answer: a syllable or word that comes before a root word
to change its meaning
◉ Pancreas. Answer: digestion and endocrine
◉ Thymus. Answer: endocrine and immune
◉ Upcoding. Answer: A fraudulent practice in which provider
services are billed for higher procedural codes than were actually
performed, resulting in a higher payment.
◉ Usual Fee. Answer: Fee for a service or procedure that is charged
by a provider for most patients under typical circumstances.
,◉ Customary fee. Answer: fee typically charged for a service in a
particular geographic area
◉ Reasonable Fee. Answer: The generally accepted fee a physician
charges for an exceptionally difficult or complicated service. A
charge is considered reasonable if it is deemed acceptable after peer
review even if it does not meet the criteria for a customary fee or
prevailing charges.
◉ Capitation. Answer: System of payment used by managed care
plans in which physicians and hospitals are paid a fixed, per capita
amount for each patient enrolled over a stated period regardless of
the type and number of services provided; reimbursement to the
hospital on a per-member/per-month basis to cover costs for the
members of the plan.
◉ Phantom Billing. Answer: Billing for services not performed
◉ Who do you report to for Fraud?. Answer: Office of Civil Rights
(OCR)
◉ Who do you report to for unsecured HPI?. Answer: Secretary of
Health and Human Services
, ◉ What is the difference between eHPI and HPI? Who governs
both?. Answer:
◉ HHS. Answer: U.S. Department of Health and Human Services
◉ U.S. Department of Health and Human Services. Answer: provide
essential services, including health care for low-income families,
programs for older adults, and child services
◉ CMS. Answer: Centers for Medicare and Medicaid Services
◉ OSHA. Answer: Occupational Safety and Health Administration
◉ Red Cross. Answer: An international organization dedicated to the
medical care of the sick or wounded in wars and natural disasters
◉ Legal Aid Society. Answer: One of a network of community law
offices that provides free or low-cost legal assistance.
◉ TJC. Answer: The Joint Commission
Organization, establishing standards for hospitals/health related
facilities
COMPLETE QUESTIONS AND ANSWERS
◉ EMR. Answer: electronic medical record
◉ suffix. Answer: word ending
◉ prefix. Answer: a syllable or word that comes before a root word
to change its meaning
◉ Pancreas. Answer: digestion and endocrine
◉ Thymus. Answer: endocrine and immune
◉ Upcoding. Answer: A fraudulent practice in which provider
services are billed for higher procedural codes than were actually
performed, resulting in a higher payment.
◉ Usual Fee. Answer: Fee for a service or procedure that is charged
by a provider for most patients under typical circumstances.
,◉ Customary fee. Answer: fee typically charged for a service in a
particular geographic area
◉ Reasonable Fee. Answer: The generally accepted fee a physician
charges for an exceptionally difficult or complicated service. A
charge is considered reasonable if it is deemed acceptable after peer
review even if it does not meet the criteria for a customary fee or
prevailing charges.
◉ Capitation. Answer: System of payment used by managed care
plans in which physicians and hospitals are paid a fixed, per capita
amount for each patient enrolled over a stated period regardless of
the type and number of services provided; reimbursement to the
hospital on a per-member/per-month basis to cover costs for the
members of the plan.
◉ Phantom Billing. Answer: Billing for services not performed
◉ Who do you report to for Fraud?. Answer: Office of Civil Rights
(OCR)
◉ Who do you report to for unsecured HPI?. Answer: Secretary of
Health and Human Services
, ◉ What is the difference between eHPI and HPI? Who governs
both?. Answer:
◉ HHS. Answer: U.S. Department of Health and Human Services
◉ U.S. Department of Health and Human Services. Answer: provide
essential services, including health care for low-income families,
programs for older adults, and child services
◉ CMS. Answer: Centers for Medicare and Medicaid Services
◉ OSHA. Answer: Occupational Safety and Health Administration
◉ Red Cross. Answer: An international organization dedicated to the
medical care of the sick or wounded in wars and natural disasters
◉ Legal Aid Society. Answer: One of a network of community law
offices that provides free or low-cost legal assistance.
◉ TJC. Answer: The Joint Commission
Organization, establishing standards for hospitals/health related
facilities
