NHA CCMA Certification Review Flashcards

Practice flashcards covering insurance terminology, clinical procedures, anatomy, pharmacology, and administrative tasks for the NHA CCMA exam.

Advance beneficiary notice (ABN)

A form provided to the patient when the provider believes Medicare will probably not pay for services received.

Allowed amount

The maximum amount a third-party payer will pay for a particular procedure or service.

Coinsurance

A policy provision whereby the policyholder and the insurance company share the cost of covered losses in a specified ratio, such as $80:20$.

Explanation of benefits (EOB)

A statement from the insurance carrier detailing what was paid, denied, or reduced in payment; it is not a bill.

Participating provider (PAR)

Providers who agree to write off the difference between the amount charged by the provider and the approved fee established by the insurer.

CHAMPVA

Insurance that covers surviving spouses and dependent children of veterans who died as a result of service-related disabilities.

Medicaid

A cost-sharing program between federal and state governments that provides health insurance to the medically indigent population.

CMS-1500 Form Section 1

The Carrier Block, which contains the address of the insurance carrier and is located at the top of the form.

Sims' position

The patient lies on their left side with the left leg straight and the right knee bent toward the chest; used for rectal exams and enemas.

Fowler's position

The patient is lying on their back with the head of the bed raised to a $90^\text{o}$ angle; used for patients with breathing trouble or heart problems.

Lithotomy position

The patient lies on their back with knees bent and legs spread apart in stirrups; primarily used for gynecological exams.

Schedule I Controlled Substances

Substances with a high potential for abuse and no approved medical use in the U.S., including heroin, mescaline, LSD, and cannabis.

Schedule II Controlled Substances

Substances with high abuse potential and no refills allowed, such as morphine, oxycodone, fentanyl, and methamphetamine.

Metric equivalent of 1 teaspoon (tsp)

$$5\text{ mL}$$

Metric equivalent of 1 tablespoon (tbsp)

$$15\text{ mL}$$

Pounds to Kilograms conversion

$$2.2\text{ lb} = 1\text{ kg}$$

Intradermal (ID) injection angle

$10^\text{o}$ to $15^\text{o}$

Subcutaneous (subQ) injection angle

$$45^\text{o}$$

Intramuscular (IM) injection angle

$90^\text{o}$.

Fat-soluble vitamins

Vitamins A, D, E, and K.

Water-soluble vitamins

Vitamins B1, B2, B3, B6, B12, folate, pantothenic acid, biotin, and Vitamin C.

Erikson's stage: Trust vs. Mistrust

The psychosocial stage associated with babies wondering if they can trust people to care for them.

Denial

A defense mechanism involving the avoidance of unpleasant situations by rejecting them or ignoring their existence.

Rationalization

A defense mechanism that provides an explanation to make something negative or unacceptable seem justifiable.

Superior (cranial)

Meaning above or closer to the head.

Medial

Closer to the midline of the body.

Sagittal plane

An imaginary flat surface that divides the body into right and left sides.

Thoracic cavity

The chest cavity, protected by the ribs, containing the heart and lungs.

Spleen

An abdominal organ that filters blood, removes old red blood cells, and helps fight infections.

Sinoatrial (SA) node

Known as the natural pacemaker of the heart, where the electrical impulse is generated.

Atrioventricular (AV) node

Known as the gatekeeper, it slows the electrical signal for the atria to finish squeezing blood into the ventricles.

Infectious agent

The first link in the chain of infection, representing the germ such as bacteria, virus, fungus, or parasite.

Normal adult heart rate

$60$ to $100\text{ bpm}$.

Normal oxygen saturation (SpO2)

95\text{%} to 100\text{%}.

Systolic pressure

The top number of a blood pressure reading, representing the force when the heart contracts.

Diastolic pressure

The bottom number of a blood pressure reading, representing the pressure when the heart relaxes.

Normal adult respiration rate

$12$ to $20\text{ breaths/min}$.

Rales (crackles)

Tiny popping sounds in the lungs, usually caused by fluid from pneumonia or heart failure.

Radial pulse

The most common site for taking an adult pulse, located on the thumb side of the wrist.

Vastus lateralis muscle

The IM injection site routinely used for vaccines in infants and children younger than $3$ years old.

Meniscus

The curved surface of a liquid; liquid medicine should be read at the lowest point of this curve at eye level.

Rule of Nines: Front of chest and abdomen

18\text{%}

Rule of Nines: Each arm

9\text{%}

Sanitization

The first step in cleaning medical equipment, reducing microbes to a lower level to prepare for disinfection or sterilization.

Disinfection

The process of destroying pathogens on a surface, often using a $1:10$ bleach solution.

Reference range for Fasting blood glucose (FBS)

$60$ to $110\text{ mg/dL}$.

Ishihara book

A screening tool used to test for color blindness, typically involving $11$ plates.

Order of Draw: Light Blue stopper

Contains Sodium citrate and is used for coagulation studies.

P wave

The EKG waveform representing atrial depolarization or contraction.

Standard EKG paper speed

$25\text{ mm/second}$.