Health Insurance and Billing (NHA
CCMA Exam)
CMS-1500 (Centers for Medicare and Medicaid Services) - Answer-basic standard claim form used by
healthcare professionals to request reimbursement for services provided to patients
encounter form/superbill - Answer-itemized form of services submitted to insurance carriers for
reimbursement of rendered services
release of information form - Answer-allows a patient access to his own medical records and allows the
patient control over to whom those records are released
Preferred Provider Organization (PPO) - Answer-managed care organization of providers, hospitals, and
other healthcare providers who have agreed with an insurer or a third-party administrator to provide
healthcare at reduced rates to the insurer's or administrator's clients
Medicaid - Answer-provides health insurance for the medically needy
Medicare - Answer-federal insurance plan that generally covers those over the age of 65 and is
considered an entitlement because those covered have paid into the system through payroll tax
Tricare - Answer-healthcare for military personnel and their dependents to receive care from civilian
providers at the expense of the federal government
Workers' Compensation - Answer-wage replacement and medical benefits for those injured on the job
CCMA Exam)
CMS-1500 (Centers for Medicare and Medicaid Services) - Answer-basic standard claim form used by
healthcare professionals to request reimbursement for services provided to patients
encounter form/superbill - Answer-itemized form of services submitted to insurance carriers for
reimbursement of rendered services
release of information form - Answer-allows a patient access to his own medical records and allows the
patient control over to whom those records are released
Preferred Provider Organization (PPO) - Answer-managed care organization of providers, hospitals, and
other healthcare providers who have agreed with an insurer or a third-party administrator to provide
healthcare at reduced rates to the insurer's or administrator's clients
Medicaid - Answer-provides health insurance for the medically needy
Medicare - Answer-federal insurance plan that generally covers those over the age of 65 and is
considered an entitlement because those covered have paid into the system through payroll tax
Tricare - Answer-healthcare for military personnel and their dependents to receive care from civilian
providers at the expense of the federal government
Workers' Compensation - Answer-wage replacement and medical benefits for those injured on the job
