NHA CCMA Study Guide - Key Vocabulary Flashcards

Comprehensive vocabulary flashcards covering medical terms, procedures, insurance, anatomy, pharmacology, legal principles, and clinical skills for the NHA CCMA certification 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.

Copayment

An amount of money that is paid at the time of medical service.

Coinsurance

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

Deductible

A specific amount of money a patient must pay out of pocket before the insurance carrier begins paying.

Explanation of benefits (EOB)

A statement from the insurance carrier detailing what was paid, denied, or reduced in payment.

Remittance advice (RA)

An explanation of benefits sent to the provider from the insurance carrier detailing payments across multiple patients and providers.

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.

Medicare

A federal government plan that generally covers patients age $65$ and older by Part A (hospitalization) or Part B (routine medical office visits) benefits.

Tricare

A government program authorizing dependents of military personnel to receive treatment from civilian providers at the expense of the federal government.

CHAMPVA

A program covering surviving spouses and dependent children of veterans who died as a result of service-related disabilities.

Medicaid

A cost-sharing health insurance program between federal and state governments for the medically indigent population who meet specific eligibility criteria.

Managed care

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.

Workers' compensation

Coverage protecting wage earners against loss of wages and the cost of medical care resulting from an occupational accident or disease.

Supine position

Lying flat on the back with the arms down to the side.

Dorsal recumbent position

Lying flat on the back with the knees bent.

Sims' position

Laying on the left side with the left leg slightly flexed and the right leg flexed at a $90^{\circ}$ angle.

Fowler's position

Sitting position with the back of the exam table raised to a $90^{\circ}$ angle.

Semi-Fowler's position

Seated leaning against the back of a table that has been raised to a $45^{\circ}$ angle.

Lithotomy position

Lying flat on the table with buttocks at the end of the table and feet resting in stirrups.

Trendelenburg position

Position where legs are elevated above the head to force circulation to vital organs, used in treating shock.

Schedule I substances

Controlled substances with a high potential for abuse and no approved medical use in the United States, such as heroin, mescaline, LSD, and cannabis.

Schedule II substances

Controlled substances with a high potential for abuse that can lead to severe dependence, requiring a handwritten prescription with no refills.

Schedule III substances

Controlled substances with moderate to low potential for dependence, requiring a handwritten prescription that may be refilled $5$ times in $6\,\text{months}$.

Schedule IV substances

Controlled substances with low potential for abuse and dependence, which may be refilled $5$ times in $6\,\text{months}$ and authorized over the phone.

Schedule V substances

Controlled substances containing limited quantities of narcotics, usually used for antidiarrheal, antitussive, and analgesic purposes.

Superior (cranial)

Above or closer to the head.

Inferior (caudal)

Below or closer to the feet.

Anterior (ventral)

Toward the front of the body.

Posterior (dorsal)

Toward the back of the body.

Medial

Closer to the midline of the body.

Lateral

Further away from the midline of the body.

Proximal

Closer to the trunk of the body.

Distal

Farther away from the trunk.

Superficial

Closer to the surface of the body.

Deep

Farther from the body's surface.

Planes of the body

Anatomical divisions including sagittal plane, coronal plane, and transverse plane.

Body cavities

Internal spaces containing organs, divided into cranial, spinal, thoracic, abdominal, and pelvic cavities.

Body quadrants

Division of the abdomen into four regions: right upper quadrant (RUQ), left upper quadrant (LUQ), right lower quadrant (RLQ), and left lower quadrant (LLQ).

Nine body regions

Anatomical division of the abdomen into right/left hypochondriac, epigastric, right/left lumbar, umbilical, right/left iliac, and hypogastric regions.

Apathy

Indifference; a lack of interest, feeling, concern, or emotion.

Compensation

A method of balancing a failure or inadequacy with an accomplishment.

Conversion

Transformation of an anxiety into a physical symptom that has no cause.

Displacement

The redirection of emotions away from its original subject or object onto another less threatening subject or object.

Projection

The transference of a person's unpleasant ideas and emotions onto someone or something else.

Rationalization

An explanation that makes something negative or unacceptable seem justifiable or acceptable.

Reaction formation

Belief in and expression of the opposite of one's true feelings.

Regression

The reversion to an earlier, more childlike, developmental behavior.

Repression

The elimination of unpleasant emotions, desires, or problems from the conscious mind.

Sublimation

Rechanneling unacceptable urges or drives into something constructive or acceptable.

Suppression

Voluntary blocking of an unpleasant experience from one's awareness.

Fat-soluble vitamins

Vitamins A, D, E, and K, whose absorption, transportation, storage, and excretion depend on fat availability.

Water-soluble vitamins

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

Sinoatrial (SA) node

The pacemaker of the heart that generates the electrical impulse.

Atrioventricular (AV) node

Known as the gatekeeper of the heart, receiving electrical impulses from the SA node.

P wave

EKG wave representing atrial depolarization or contraction.

QRS wave

EKG wave representing ventricular depolarization or contraction.

T wave

EKG wave representing ventricular repolarization or relaxation.

EKG Waveforms, intervals, and segments

The distinct electrical readings recorded during a cardiac cycle, including P wave, PR interval, QRS complex, ST segment, T wave, and QT interval.

Chest lead placement

Anatomy layout for placing precordial leads V1 through V6 on specific intercostal spaces of the chest wall.

Medical asepsis

Clean technique used daily to reduce the number of micro-organisms and prohibit their growth after leaving the body.

Surgical asepsis

Sterile technique involving the complete removal of all micro-organisms, required during invasive procedures.

Sanitization

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

Disinfection

The process of destroying pathogens on a surface using chemical solutions such as glutaraldehyde or a $1:10$ bleach solution.

Agents of indirect transmission

Infection transmission modes including living vectors (e.g., mosquitoes) and inanimate fomites (e.g., contaminated objects).

Intradermal injection (ID)

Injection administered into the skin at a $10^{\circ}$ to $15^{\circ}$ angle using a $27$ to $28$ gauge, $3/8\,\text{inch}$ needle.

Subcutaneous injection (SC)

Injection administered into subcutaneous tissue at a $45^{\circ}$ angle using a $25$ to $26$ gauge, $1/2\,\text{inch}$ or $5/8\,\text{inch}$ needle.

Intramuscular injection (IM)

Injection administered into muscle at a $90^{\circ}$ angle using a $20$ to $23$ gauge, $1$ to $3\,\text{inch}$ needle.

Vastus lateralis muscle

An IM injection site located in the mid to upper outer thigh, routinely used for infants and children under $3\,\text{years}$ old.

Rule of Nines

A standardized system used to estimate the percentage of total body surface area affected by burns.

Order of draw

The correct sequence of stopper colors when drawing blood to prevent additive cross-contamination.

Vein anatomy for venipuncture

Primary veins in the antecubital fossa used for blood draws: median cubital, cephalic, and basilic veins.

Accounts receivable

The total amount owed to the provider for medical services rendered.

Accounts payable

Debt incurred by a practice that has not yet been paid, such as for supplies or utilities.

Misdemeanor

A crime considered less serious than a felony, carrying a penalty of a fine or imprisonment for less than $1\,\text{year}$.

Felony

A serious crime constituting a penalty of imprisonment greater than $1\,\text{year}$ or death.

Assault

An instance in which someone threatens to cause harm to an individual.

Battery

Intentional touching or use of force in a harmful manner without the individual's consent.

Subpoena

A written order that commands someone to appear in court to give evidence.

Deposition

A formal statement in which an individual promises under oath to tell the truth before a case is brought to trial.

Precertification

A process required by insurance carriers in which the provider must prove medical necessity before performing a procedure.

Patient-Centered Medical Home (PCMH)

A care delivery model coordinated through a primary care provider to ensure comprehensive, centralized, and team-based patient care.

Malfeasance

Performance of an unlawful, wrongful act.

Misfeasance

Performance of a lawful action in an illegal or improper manner.

Nonfeasance

Failure to perform a task, duty, or undertaking that one has agreed or has a legal duty to perform.