NHA CCMA Module 1

patient education

Information provided to patients specific to the needs of that patient, related to their specific disease, treatment, or plan of care.

Maslow’s Hierarchy of Human Needs

he most basic needs, such as food and water, are at the bottom of the pyramid. The next levels include safety, then love and belonging. The basic, simpler needs support a person’s ability to achieve psychological needs, such as belongingness, love, and esteem. Self-actualization is achieving one’s highest potential and creativity.

scope of practice

A specific set of standards that a medical professional may perform within the limits of the medical license, registration, and/or certification.

Characteristics of Medical Assistants

Effective communication

Professional Behavior

Respectful Demeanor

Which of the following reflects Maslow’s theory of self-actualization?

A. Everyone can move up and meet their needs.

B. Only individuals who have assistance that can meet their needs.

C. Individuals with unsatisfied needs will give up on attaining those needs.

D. Individuals will decline if their needs are met too easily.

A. Everyone can move up and meet their needs.

Which health care facility is a medical assistant most likely to be employed at?

A. Pharmaceutical research center

B. Family practice

C. Birthing center

D. Imaging and radiology center

B. Family practice

Which of the following can provide medical assisting certification examinations?

A. State licensing office

B. Medical board

C. Medical assistant’s employer

D. Health care certification agency

D. Health care certification agency

Doctors of Medicine (MD)

MDs can diagnose and treat illnesses as well as help patients with disease maintenance and prevention.

• 4-year undergraduate degree

• 4 years of medical school

• 3 to 8 years of internship and residency

• Pass all sections of the United States Medical Licensing Examination (USMLE)

Doctor of Osteopathic Medicine (DO)

DOs provide the same services as physicians, with an emphasis on the body’s musculoskeletal and nervous system, preventive medicine, holistic patient care, and patient education.

• 4-year undergraduate degree

• 4 years of medical school

• 3 to 8 years of internship and residency

• Pass all sections of the United States Medical Licensing Examination (USMLE)

Physician specialist

Physician specialists provide specialized care in a specific field of medicine (e.g., dermatology, cardiology, family practice, gynecology, neurology, oncology, or sports medicine).

• 4-year undergraduate degree

• 4 years of medical school

• 3 to 8 years of internship and residency

• 2 to 6 years of study in a specialized area of medicine

• Pass all sections of the United States Medical Licensing Examination (USMLE) and also necessary boards associated with selected specialty

Physician associate/Physician assistant (PA)

PAs are able to examine patients, order diagnostic tests, and prescribe certain medications. They are usually directed by a supervising physician.

• Master’s degree, usually focused on science or health care, from an accredited program

• Internship experience volunteering or working in a health care setting

• Pass the Physician Assistant National Certifying Exam (PANCE) administered by the National Commission on Certification of Physician Assistants (NCCPA)

• Obtain a license in the state in which you are practicing

Nurse practitioner (NP)

NPs are able to examine patients, order diagnostic tests, and prescribe certain medications. They can practice independently without physician oversight depending on state regulations.

• Bachelor’s degree in nursing

• 1 to 2 years of clinical experience

• Master of Science in Nursing (MSN)

• Pass a national certification exam from an accredited body

Nurse RN/LPN/LVN

Nurses protect, promote, and optimize health for patients, in addition to assisting with disease prevention and injuries. Nurses serve as a patient advocate.

• RN 

  • 2 to 4 years of nursing school

  • Pass the National Council Licensure Exam

• LPN/LVN  

  • Accredited program, usually 12 to 18 months

  • Pass state licensure exam

Lab technicians

Lab technicians perform chemical, microscopic, and bacteriologic test on blood, tissue, and body fluids under the supervision of a pathologist.

• 2-year associate's degree in clinical laboratory science

• Many states require passing the American Society for Clinical Pathology certification

Health information specialist

These specialists work with medical records, provide assistance in planning, manage information, gather data for medical research, and establish polices.

• Certificate, diploma, or degree in health information

• Many states require passing the American Health Information Management Association certification

comprehensive care

Care designed for the patient’s physical and mental health needs with a team-based approach.

Ambulatory Surgery Centers

surgical services that usually do not require an overnight stay; these are considered outpatient

Medical Clinics

outpatient setting

Telehealth

telecommunication technology. This can include video, online portals, and email.

Mobile Health Units

usually serves vulnerable populations. These units could be in rural areas that may not have health care readily available.

Patient-Centered Medical Home (PCMH)

A partnership between a patient and their care team in which total health is the focus, not just a single condition. A health care team consists of a provider (physician, nurse practitioner, physician assistant), CMAA, CCMA, nurses, and pharmacists.

Obstetrician/Gynecologist

Specializes in care regarding menstruation, breasts, pregnancy, and reproductive organs (cervix, uterus, ovaries, fallopian tubes, and vagina), including health screenings, diagnostic procedures, hormone therapy, and prenatal, delivery, and postpartum care

Cardiologist

Specializes in treatment and diagnosis of conditions of the cardiovascular system

Endocrinologist

Specializes in treatment and diagnosis of conditions of the endocrine system (e.g., diabetes, thyroid, growth issues, and adrenal and pituitary glands)

Pediatrician

Specializes in treatment and care for children, from birth to adulthood (ceasing care sometime between the ages of 18 and 21)

Family medicine

Specializes in routine care for adults and children

Orthopedic medicine

Specializes in diagnosing and treating diseases or injuries of the musculoskeletal system

health care reimbursement

Payments received for health care services provided.

fee for service

Reimbursement method that pays claims based on a contracted fee schedule amount. The provider of service submits itemized claims with the cost determined by the provider. The claims are processed and adjudicated by the payer, and any amounts billed that are over the fee schedule amount are adjusted off by the provider. The adjusted amount is not patient responsibility.

managed care plan

Used by private and public insurance plans. This payment model uses administrative methods and clinical utilization review to reduce health care costs, while promoting preventive care and age-appropriate screenings to improve the health and wellness of patients. The three types of managed care plans are health maintenance organization (HMO), preferred provider organization (PPO), and point of care (POS) service.

capitation

A reimbursement method that pays health care providers a fixed prepayment for all necessary contracted services for each enrolled member. The capitated rate is typically paid monthly. The payment per patient remains the same, regardless of how many times a patient is seen. Capitation can also be defined as a fixed amount paid per claim, regardless of the (contracted) services rendered. 

value-based plan

A reimbursement model also referred to as pay-for-performance. This type of reimbursement offers incentives for providers who meet the program defined quality measures for preventive care services and management of chronic conditions. It usually includes cost incentives as well. Providers can meet this targeted area by providing efficient care such as preventing hospital readmissions, reducing emergency department visits and redundant tests and imaging.

Which of the following types of medical practice specializes in treating diseases and injuries of the skeletal system?

A. Orthodontics

B. Orthopedics

C. Pediatrics

D. Obstetrics

B. Orthopedics

Which of the following payment models requires the insurance company to pay predetermined payment amounts for their members?

A. Fee for service

B. Capitation

C. Value-based plans

D. Managed care

B. Capitation

coordinated care

Patient care that is coordinated across the health care system, such as any specialty care, hospitals, home health care, and community services that the patient has available or is using.

accesible services

Efforts to make primary care accessible by minimizing wait times to see a provider, as well as increasing office hours and after-hours access to providers using different methods (e.g., telephone, video, and email).

quality and safety

Helps provide safe quality care using clinical decision support tools or resources, evidence-based care, shared decision-making, performance measurements, and population health management. Sharing data and improvement plans with different populations can help contribute to a higher level of quality.

health coaching

Promotion of strategies aimed at improving overall health (e.g., encouraging a patient to begin an exercise program with the guidance of their provider).

Health considerations

Poverty

Language

Social Injustice

Culture

patient navigator

Individual that can work with the patient and providers to navigate the patient’s care to help them better understand how to access and receive treatment if there are obstacles involved. This role is often filled by the medical assistant.

Which of the following is an attribute of patient navigation?

A. Establishing a one-on-one relationship with patient

B. Assisting with financial issues

C. Being sensitive to social injustice

D. Providing a patient with your personal cell phone number

A. Establishing a one-on-one relationship with patient

Which coordination of care model is designed to care for the patient’s physical and mental care using a team-based approach?

A. Accessible care

B. Comprehensive care

C. Patient-centered care

D. Coordinated care

B. Comprehensive care

Which of the following is the primary goal of the medical assistant serving as the patient navigator?

A. Increase quality and effectiveness of patient care

B. Obtain the optimal reimbursement for the provider

C. Make the patient be responsible for their own health

D. Take some of the provider’s responsibilities away

A. Increase quality and effectiveness of patient care

An MA in a general practice office calls a patient to remind them of an upcoming appointment. The patient speaks Spanish, and they do not understand the MA, who speaks English. Which action should the MA take?

A. Speak slowly and loudly to the patient until they understand

B. Obtain a telephone translator on a three-way call to the patient

C. Ask the patient if they have any family with them who can speak English

D. Tell the provider they cannot communicate with the patient

B. Obtain a telephone translator on a three-way call to the patient