CCMA Exam 2025–2026 – NHA Certified Clinical Medical Assistant Study Guide & Practice
A form provided to the patient when the provider believes Medicare will probably not pay for services
received. - (answer)Advance beneficiary notice (ABN)
The maximum amount a third-party payer will pay for a particular procedure or service. -
(answer)Allowed amount
An amount of money that is paid at the time of medical service by the patient. - (answer)Copayment
A form of cost-sharing in which the insurance carrier pays a percentage of the claim and the patient pays
the remaining percentage. Medicare, for example, has an 80-20 coinsurance, in which Medicare pays
80% and the patient pays 20% of the charges. - (answer)Coinsurance
A specific amount of money a patient must pay out of pocket before the insurance carrier begins paying.
- (answer)Deductible
A statement from the insurance carrier detailing what was paid, denied, or reduced in payment; also
contains information about amounts applied to the deductible, coinsurance, and allowed amounts. AKA
SUPERBILL - (answer)Explanation of benefits
contracts with a health insurance plan and accepts whatever the plan pays for procedures or services
performed - (answer)Participating provider (PAR)
A federal health insurance program generally covering patients age 65 and older by Part A (Inpatient) or
Part B (outpatient), Part C (Both), Part D (Prescription) benefits. - (answer)Medicare
A program that authorizes dependents of military personnel to receive treatment from civilian providers
at the expense of the federal government. - (answer)Tricare
A program that covers surviving spouses and dependent children of veterans who died as a result of
service-related disabilities. - (answer)CHAMPVA
,CCMA Exam 2025–2026 – NHA Certified Clinical Medical Assistant Study Guide & Practice
A program that 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. -
(answer)Medicaid
An umbrella term for health insurance plans that provide health care. Defined network of providers and
hospitals.(HMO, PPO, POS) - (answer)Managed care
A program that protects wage earners against the loss of wages and the cost of medical care resulting
from an occupational accident or disease as long as the employee is not proven negligent. -
(answer)Workers' compensation
The health insurance claim form most health care payers use for claims submitted by a provider or
supplier. AKA SUPERBILL - (answer)CMS-1500 Form
A route of administration involving the epidural space (spine) for injectable liquid. - (answer)Epidural
A route of administration involving arteries (to break up clots) for injectable liquid. - (answer)Intra-
arterial
A route of administration within a joint space for injectable liquid. - (answer)Intra-articular
A route of administration involving major veins, most often in the arms and hands, or via central venous
access devices for injectable liquid. - (answer)Intravenous (IV)
Vitamins A, D, E, K are absorbed and dissolved in fat and stored in the body's tissues (liver, fat cells). -
(answer)Fat-soluble vitamins
Vitamins B1, B2, B3, B6, folate, B12, pantothenic acid, biotin, and Vitamin C are absorbed and dissolved
in water and obtained regularly through regular consumption. - (answer)Water-soluble vitamins
, CCMA Exam 2025–2026 – NHA Certified Clinical Medical Assistant Study Guide & Practice
ILLEGAL!!! Substances that have a high potential for abuse and no approved medical use in the United
States, such as heroin and LSD. - (answer)Schedule I substances
NO REFILLS! Substances that have a high potential for abuse and can lead to psychological and physical
dependence, such as morphine and oxycodone. - (answer)Schedule II substances
5 REFILLS IN 6 MONTHS!. Substances that have a moderate to low potential for physical and
psychological dependence, such as ketamine and anabolic steroids. - (answer)Schedule III substances
5 REFILLS IN 6 MONTHS! Substances that have a low potential for abuse and dependence, such as
diazepam and alprazolam. - (answer)Schedule IV substances
A YEAR REFILL! Substances that contain limited quantities of some narcotics, usually for antidiarrheal,
antitussive, and analgesic purposes, such as diphenoxylate with atropine. - (answer)Schedule V
substances
Conversions between household values and their apothecary and metric equivalents. -
(answer)Household measurements
Divide by 2.2 = Kg
Multiple by 2.2 = lb - (answer)Conversion from lb to Kg
8 stages of development - (answer)Erikson's stages of psychosocial development
Infant: form and attachment with trust in their caregiver or mistrust: struggle with intrapersonal
relationship - (answer)Trust vs Mistrust
Toddlers: Sense of independence/autonomy or Doubt: lack of self-confidence - (answer)Autonomy vs
Shame and Doubt
Preschooler: Active imagination/achievement or guilt: defeat/inadequacy - (answer)Initiative vs Guilt
A form provided to the patient when the provider believes Medicare will probably not pay for services
received. - (answer)Advance beneficiary notice (ABN)
The maximum amount a third-party payer will pay for a particular procedure or service. -
(answer)Allowed amount
An amount of money that is paid at the time of medical service by the patient. - (answer)Copayment
A form of cost-sharing in which the insurance carrier pays a percentage of the claim and the patient pays
the remaining percentage. Medicare, for example, has an 80-20 coinsurance, in which Medicare pays
80% and the patient pays 20% of the charges. - (answer)Coinsurance
A specific amount of money a patient must pay out of pocket before the insurance carrier begins paying.
- (answer)Deductible
A statement from the insurance carrier detailing what was paid, denied, or reduced in payment; also
contains information about amounts applied to the deductible, coinsurance, and allowed amounts. AKA
SUPERBILL - (answer)Explanation of benefits
contracts with a health insurance plan and accepts whatever the plan pays for procedures or services
performed - (answer)Participating provider (PAR)
A federal health insurance program generally covering patients age 65 and older by Part A (Inpatient) or
Part B (outpatient), Part C (Both), Part D (Prescription) benefits. - (answer)Medicare
A program that authorizes dependents of military personnel to receive treatment from civilian providers
at the expense of the federal government. - (answer)Tricare
A program that covers surviving spouses and dependent children of veterans who died as a result of
service-related disabilities. - (answer)CHAMPVA
,CCMA Exam 2025–2026 – NHA Certified Clinical Medical Assistant Study Guide & Practice
A program that 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. -
(answer)Medicaid
An umbrella term for health insurance plans that provide health care. Defined network of providers and
hospitals.(HMO, PPO, POS) - (answer)Managed care
A program that protects wage earners against the loss of wages and the cost of medical care resulting
from an occupational accident or disease as long as the employee is not proven negligent. -
(answer)Workers' compensation
The health insurance claim form most health care payers use for claims submitted by a provider or
supplier. AKA SUPERBILL - (answer)CMS-1500 Form
A route of administration involving the epidural space (spine) for injectable liquid. - (answer)Epidural
A route of administration involving arteries (to break up clots) for injectable liquid. - (answer)Intra-
arterial
A route of administration within a joint space for injectable liquid. - (answer)Intra-articular
A route of administration involving major veins, most often in the arms and hands, or via central venous
access devices for injectable liquid. - (answer)Intravenous (IV)
Vitamins A, D, E, K are absorbed and dissolved in fat and stored in the body's tissues (liver, fat cells). -
(answer)Fat-soluble vitamins
Vitamins B1, B2, B3, B6, folate, B12, pantothenic acid, biotin, and Vitamin C are absorbed and dissolved
in water and obtained regularly through regular consumption. - (answer)Water-soluble vitamins
, CCMA Exam 2025–2026 – NHA Certified Clinical Medical Assistant Study Guide & Practice
ILLEGAL!!! Substances that have a high potential for abuse and no approved medical use in the United
States, such as heroin and LSD. - (answer)Schedule I substances
NO REFILLS! Substances that have a high potential for abuse and can lead to psychological and physical
dependence, such as morphine and oxycodone. - (answer)Schedule II substances
5 REFILLS IN 6 MONTHS!. Substances that have a moderate to low potential for physical and
psychological dependence, such as ketamine and anabolic steroids. - (answer)Schedule III substances
5 REFILLS IN 6 MONTHS! Substances that have a low potential for abuse and dependence, such as
diazepam and alprazolam. - (answer)Schedule IV substances
A YEAR REFILL! Substances that contain limited quantities of some narcotics, usually for antidiarrheal,
antitussive, and analgesic purposes, such as diphenoxylate with atropine. - (answer)Schedule V
substances
Conversions between household values and their apothecary and metric equivalents. -
(answer)Household measurements
Divide by 2.2 = Kg
Multiple by 2.2 = lb - (answer)Conversion from lb to Kg
8 stages of development - (answer)Erikson's stages of psychosocial development
Infant: form and attachment with trust in their caregiver or mistrust: struggle with intrapersonal
relationship - (answer)Trust vs Mistrust
Toddlers: Sense of independence/autonomy or Doubt: lack of self-confidence - (answer)Autonomy vs
Shame and Doubt
Preschooler: Active imagination/achievement or guilt: defeat/inadequacy - (answer)Initiative vs Guilt
