CMAA EXAM #1 patient encounter

Flashcards for CMAA exam review focusing on patient check-in processes, demographic information, communication accommodations, and telehealth appointments.

What is the check-in process performed by the CMAA?

Greeting and registering patients, which sets the tone for their experience with the health care organization.

Why is it important for a CMAA to have a professional manner and genuine disposition?

To create a positive impression and support the overall patient relationship with the provider and the health care organization.

Before a patient arrives for their scheduled appointment, what information should the CMAA know?

The CMAA should know the patient's insurance coverage, if the provider is in-network, and whether the organization provides the necessary services.

What does demographic information include, and why is it important?

Including contact information and insurance details, and it is used to create insurance claims.

What information needs to be collected/verified at the time of the patient's appointment?

Scan or copy insurance cards and verify patient identity with photo identification.

What is the definition of 'new patients'?

Patients not seen by the provider (or a provider of the same specialty within the group) for three years.

When performing patient check-in tasks, what should the CMAA always do?

Obtain demographic information, check for changes in primary, secondary, or tertiary insurance, and determine the coordination of benefits (COB).

What is primary insurance?

The insurance plan responsible for paying health care insurance claims first.

What is secondary insurance?

The insurance plan that is billed after the primary insurance plan has paid its contracted amount.

What is tertiary insurance?

Insurance coverage in addition to primary and secondary insurance, covering gaps in their coverage.

What is coordination of benefits (COB)?

A provision that prevents multiple insurers from paying benefits covered by other policies and specifies the order of coverage.

What is coinsurance?

The percentage of the allowed amount the patient pays after meeting the deductible.

What is a copayment?

A fixed amount the patient pays for specified services, like office or emergency department visits.

What is a deductible?

The amount the patient must pay before the insurance starts paying benefits.

How do patient demographics impact the revenue cycle?

The information entered into the EHR impacts the potential reimbursement of the claim.

How does effective communication occur, and why is it important?

Verbally and nonverbally, being proactive to ensure patients have a positive and satisfactory health care experience.

What are visual accommodations that should be made for patients?

Provide screens or printouts with larger font.

What is the best approach when communicating with patients who have hearing loss?

Ask the patient their preference for communicating, considering options like sign language interpreters or speech-to-text apps.

What is Telehealth?

The delivery of health care services through live, interactive video conferencing.

Why is it important for the CMAA to inform the patient of the type of equipment they use and gauging their familiarity.

The CMAA should inform the patient that telehealth is the same as an in-person visit. The CMAA will have to explain to prepare the patient for an upcoming telehealth appointment.

What does the patient need for a telehealth appointment?

A stable internet connection and a safe, private place free of distractions.

How do you ensure an efficient visit can be held.

Providing the patient with an access link and troubleshooting steps.