#1 – Foundational Knowledge & Basic Science

Fifty Question-and-Answer style flashcards summarizing key concepts from CCMA Exam Prep lecture #1, covering healthcare systems, medical assisting duties, insurance, terminology, pharmacology, nutrition, psychology, and more.

In an HMO, what role does the primary care physician (PCP) typically play?

The PCP acts as the “gatekeeper,” providing all routine care and coordinating referrals; care not routed through the PCP (except emergencies) is not covered.

List the four types of HMO models.

Group Model, Individual Practice Association (IPA) Model, Network Model, and Staff Model.

What does PPO stand for, and what incentive encourages members to use preferred providers?

Preferred Provider Organization; members receive significantly better benefits (lower cost-sharing) when using preferred providers.

How does a Point-of-Service (POS) plan handle care from nonparticipating providers?

Members may choose nonparticipating providers but pay substantially higher costs through increased premiums, deductibles, and coinsurance.

Name two positive outcomes associated with the Patient-Centered Medical Home (PCMH) model.

Examples include effective chronic disease management, increased patient and provider satisfaction, cost savings, improved quality of care, and greater preventive care.

What is an Accountable Care Organization (ACO) designed to accomplish?

Coordinate care to deliver the right care at the right time, reduce unnecessary utilization and errors, and share savings (or losses) linked to total patient-care costs.

Define hospice care in one sentence.

Hospice focuses on maximizing comfort and quality of life for people in the last phases of an incurable, life-limiting illness.

In the collaborative care model, which three professionals form the core team?

Primary care providers, care managers, and psychiatric consultants.

What does the pay-for-performance (P4P) model reward?

Healthcare providers receive financial incentives for meeting specified quality or performance measures.

Upon what three factors is a medical assistant’s scope of practice based?

Education, training, and state-specific regulations/certification.

Name any two additional credentials (beyond CCMA) available to medical assistants.

Possible answers: CPT, CET, CBCS, or CEHRS.

Give one advantage of obtaining certification as a medical assistant.

Higher likelihood of initial job placement, higher wages, or improved career advancement opportunities.

Which specialist examines body tissues and fluids under a microscope to identify disease causes?

Pathologist.

Which specialist treats hormone-related disorders such as diabetes and thyroid disease?

Endocrinologist.

What type of physician specializes in internal organs, treats adults only, and is considered primary care?

Internist.

What is the primary eligibility difference between Medicare and Medicaid?

Medicare is a federal program mainly for people 65+ or certain disabled individuals, whereas Medicaid is a needs-based federal-state program for qualifying low-income groups.

Which insurance program provides medical coverage to dependents of military personnel?

TRICARE (formerly CHAMPUS).

Which document from an insurer explains what was paid, denied, or reduced on a claim?

Explanation of Benefits (EOB).

Define a deductible in medical insurance.

A set amount the patient must pay out of pocket before the insurance carrier starts paying benefits.

What does an 80/20 coinsurance split mean?

The insurer pays 80% of covered costs and the insured pays the remaining 20%.

What is a participating provider (PAR)?

A healthcare provider who contracts with an insurance company and agrees to its rules and fee schedule.

In medical terminology, which root word refers to skin?

derm

Which prefix means “fast”?

tachy-

What does the suffix “-ectomy” indicate?

Surgical removal (excision) of something.

Which directional term means “toward the head”?

Superior (cranial).

Which anatomical plane divides the body into right and left parts?

Sagittal plane.

Which injection route deposits medication into the subcutaneous fat layer?

Subcutaneous (SQ) injection.

Why do rectal medications often require smaller doses for rapid effect?

They bypass liver (first-pass) metabolism, allowing quicker systemic absorption.

Schedule I drugs share what two key characteristics?

They have a high potential for abuse and no currently accepted medical use in the United States.

Give one Schedule II medication named in the lecture.

Examples: Oxycodone (OxyContin), hydromorphone (Dilaudid), fentanyl, methadone, cocaine, etc.

Under which schedule are anabolic steroids classified?

Schedule III.

Which drug schedule includes medications like Xanax and Valium?

Schedule IV.

Cough preparations with less than 200 mg codeine per 100 mL belong to which schedule?

Schedule V.

Name the four primary pharmacokinetic processes.

Absorption, distribution, metabolism, and excretion.

How many milliliters are in one teaspoon?

5 mL (or 5 cc).

According to the six rights, when should a medication administration be documented?

Immediately and completely after the drug is given, including how it was tolerated.

Which macronutrient is primarily used for energy and listed first in the nutrition components?

Carbohydrates.

Which item on a USDA food label tells you how much energy one serving provides?

Calories per serving.

Name one of the three most common eating disorders.

Anorexia nervosa, bulimia nervosa, or binge-eating disorder.

During which Erikson stage does Identity vs. Confusion occur, and what ages does it cover?

Stage 5, ages 12–18 (the teen years).

What is the highest level in Maslow’s hierarchy of needs?

Self-actualization.

Which stage of grief is characterized by frustration and irritability?

Anger.

Which measurement abbreviation is equivalent to 1 milliliter?

cc (cubic centimeter).

What form of medication is designed to be chewed before swallowing?

Chewable tablet.

What does the suffix “-scopy” indicate about a procedure?

It involves using an instrument for viewing or examining.

What directional term describes a structure farther from the point of limb attachment?

Distal.

What does the suffix “-stomy” signify in surgical terminology?

Creation of a surgical opening (stoma).

Which medication route delivers drugs by drops to the eyes, ears, or nose?

Instillation.

Name two essential electrolytes listed under minerals in the nutrition section.

Any two of the following: magnesium, potassium, sodium.

What is the purpose of an Advanced Beneficiary Notice (ABN) for Medicare Fee-for-Service patients?

To inform beneficiaries that a service or item may not be covered so they can decide whether to receive it and accept possible financial responsibility.