CCMA NHA FINAL PAPER 2026 QUESTIONS
WITH SOLUTIONS GRADED A+
◉Allowed Amount. Answer: The maximum amount a third-party
payer will pay for a particular procedure or service
◉Copayment. Answer: a small fixed fee paid by the patient at the
time of an office visit
◉Coinsurance. Answer: a provision under which both the insured
and the insurer share the covered losses, typically 80:20
◉deductible. Answer: specific amount of money a patient must pay
out of pocket before the insurance carrier begins paying
◉Explanation of Benefits. Answer: a form created by the insurance
company to explain what charges were covered, denied, or need
more documentation based on the claims submitted by the
physician's office
,◉Participating provider (PAR). Answer: Providers who agree to
write off the difference between the amount charged by the provider
and the approved fee established by the insurer
◉Medicare. Answer: A federal program of health insurance for
persons 65 years of age and older by Part A (hospitalization) or Part
B (routine medical office visits)
◉Tricare. Answer: U.S. government health insurance plan for all
military personnel
◉CHAMPVA. Answer: covers surviving spouses and dependent
children of veterans who died as a result of service-related
disabilities
◉Medicaid. Answer: provides health insurance to the medically
indigent population through a cost-sharing program between
federal and state governments for those who meet specific eligibility
criteria
◉Managed Care. Answer: is an umbrella term for plans that provide
health care in return for preset scheduled payments and
coordinated care through a defined network of providers and
hospitals
,◉CMS-1500 form. Answer: Standard insurance form used by all
government and most commercial insurance payers.
- 33 blocks
- divided into three section
◉CMS-1500 Section 1. Answer: Carrier Block: contains the address
of the insurance carrier and is located at the top of the form
◉CMS-1500 Section 2. Answer: Patient/insured section: contains
information about the patient or insured; includes boxes 1-13
◉CMS-1500 Section 3. Answer: Physician/Supplier Section: contains
information about the physician or supplier: boxes 14-33
◉Supine Position. Answer:
◉Dorsal Recumbent Position. Answer:
◉Sims' Position. Answer:
◉Knee-elbow position. Answer:
◉Fowler's Position. Answer:
, ◉Lithotomy Position. Answer:
◉Epidural Injection. Answer: epidural space of the spine
◉Intra-arterial Injection. Answer: injection into an artery (to break
up clots)
◉Intra-articular Injection. Answer: injection into joint space
◉Intradermal Injection. Answer: Skin of the upper chest, forearms,
upper pack. 5-15º angle
◉intramuscular injection. Answer: deltoid, vastus lateralis,
ventrogluteal muscles
◉Intraosseous Injection. Answer: Bone marrow
◉Intraperitoneal Injection. Answer: within the peritoneal cavity
◉Intrapleural Injection. Answer: pleural space (lungs)
WITH SOLUTIONS GRADED A+
◉Allowed Amount. Answer: The maximum amount a third-party
payer will pay for a particular procedure or service
◉Copayment. Answer: a small fixed fee paid by the patient at the
time of an office visit
◉Coinsurance. Answer: a provision under which both the insured
and the insurer share the covered losses, typically 80:20
◉deductible. Answer: specific amount of money a patient must pay
out of pocket before the insurance carrier begins paying
◉Explanation of Benefits. Answer: a form created by the insurance
company to explain what charges were covered, denied, or need
more documentation based on the claims submitted by the
physician's office
,◉Participating provider (PAR). Answer: Providers who agree to
write off the difference between the amount charged by the provider
and the approved fee established by the insurer
◉Medicare. Answer: A federal program of health insurance for
persons 65 years of age and older by Part A (hospitalization) or Part
B (routine medical office visits)
◉Tricare. Answer: U.S. government health insurance plan for all
military personnel
◉CHAMPVA. Answer: covers surviving spouses and dependent
children of veterans who died as a result of service-related
disabilities
◉Medicaid. Answer: provides health insurance to the medically
indigent population through a cost-sharing program between
federal and state governments for those who meet specific eligibility
criteria
◉Managed Care. Answer: is an umbrella term for plans that provide
health care in return for preset scheduled payments and
coordinated care through a defined network of providers and
hospitals
,◉CMS-1500 form. Answer: Standard insurance form used by all
government and most commercial insurance payers.
- 33 blocks
- divided into three section
◉CMS-1500 Section 1. Answer: Carrier Block: contains the address
of the insurance carrier and is located at the top of the form
◉CMS-1500 Section 2. Answer: Patient/insured section: contains
information about the patient or insured; includes boxes 1-13
◉CMS-1500 Section 3. Answer: Physician/Supplier Section: contains
information about the physician or supplier: boxes 14-33
◉Supine Position. Answer:
◉Dorsal Recumbent Position. Answer:
◉Sims' Position. Answer:
◉Knee-elbow position. Answer:
◉Fowler's Position. Answer:
, ◉Lithotomy Position. Answer:
◉Epidural Injection. Answer: epidural space of the spine
◉Intra-arterial Injection. Answer: injection into an artery (to break
up clots)
◉Intra-articular Injection. Answer: injection into joint space
◉Intradermal Injection. Answer: Skin of the upper chest, forearms,
upper pack. 5-15º angle
◉intramuscular injection. Answer: deltoid, vastus lateralis,
ventrogluteal muscles
◉Intraosseous Injection. Answer: Bone marrow
◉Intraperitoneal Injection. Answer: within the peritoneal cavity
◉Intrapleural Injection. Answer: pleural space (lungs)
