CMAA Review POWER POINT #1 CMAA Information for Allied Health III ( P-Point 1) IT IS IMPORTANT TO KNOW THE SCOPE OF A CMAA’S (CERTIFIED MEDICAL ADMINISTRATIVE ASSISTANT) JOB DUTIES, AND WHAT THEY CAN AND CANNOT DO. THIS POWER POINT, AND THE 2 FOLLOWING POWER POINTS, CONTAINS USEFUL INFORMATION THAT WILL HELP YOU PREPARE FOR THE CMAA INDUSTRY EXAM. THE ACTUAL CMAA EXAM CONTAINS 110 MULTIPLE CHOICE QUESTIONS. T H E E X A M D A T E S W I L L B E A P R I L 3 0 TH F O R S E N I O R S A T 9:00 AM IN ROOM 135 (JUNIOR’S DATE TBA). LAST DAY T O R E G I S T E R I S A P R I L 2 2 ND Important Items in this Power Point that have an * in front are most likely to be asked on the CMAA exam in some form. Make sure you study these well. This Power Point contains practice questions 1 - 33. Power point # 2 for the rest of the information and practice questions. Always Keep in Mind…….. A CMAA, or MAA (Medical Administrative Assistant), is basically trained to do front office work that includes secretarial skills. When in doubt about a question about CMAAs, always think about what a secretary would be allowed to do at a medical office, and what they would not be allowed to do. On the CMAA Exam, don’t think from the perspective of a nurse or doctor, or any other health care worker that we teach about in health science classes. Just think from the perspective of a front desk person with no medical training. This can help you narrow down your answers to the best answer. Remember, MAAs have no medical training, and you should apply this to your responses. Medical Specialties There may be a few questions on Medical Specialties, and which organs & disorders certain specialists work with on a regular basis. For example: If you were told you had an MI, or Myocardial Infarction (heart attack), the specialist you would see would be a Cardiologist. *Specialists to Know about and what kind of referrals they get. *Cardiologist (heart specialist) – MI, Angina, CHF (congestive heart failure), Hypertension, EKG interpretations, etc. *Pulmonologist (lung specialist) – COPD, asthma, emphysema, lung cancer, etc. Gastroenterologist (stomach & intestines) – colon cancer, ulcers, digestive system disorders Neurologist (Nervous system) – EEG interpretation, brain tumors, spinal injuries, head injuries, seizures *Nephrologist ( renal functions & kidneys) – dialysis and renal failure, etc. Specialists Question (1 of 150) • A patient calls with history of an MI and CHF, and • • • • needs to be referred to a specialist. Which specialist would the Medical Assistant contact? A. neurologist B. cardiologist C. urologist D. pulmonologist Answer B. Cardiologist (MI is a myocardial infarction and CHF is congestive heart failure) Specialists Question (2 of 150) *A patient calls a multi-specialty practice to schedule a consult to discuss the results of a renal function panel. With which of the following providers should the patient be scheduled? A. Hematologist B. Gynocologist C. Nephrologist D. Endocrinologist Answer: C (Nephrologists deal with kidneys, or renal functions) FILING *Alphabetical Filing: Folders are arranged in the same sequence of the alphabet The Medical Assistant must ensure that the filing cabinet has enough space for proper distribution of the files amongst each letter of the alphabet. RECORDS MANAGEMENT FILING Numerical Filing: An alphabetic cross-reference is used to categorize materials with digits Patients are assigned in a consecutive number Records are filed backwards in groups Example: Terminal digit filing FILING. On the CMAA exam, you may have to place a list of names in order, or state “which comes 2nd, 3rd etc.” The Medical Administrative should use the following indexing rules for alpha. order: Last Name, First Name, Middle Name/Initial Always remember, “nothing comes before something”, such as Brown, Mark is filed before Brown, Mark A. The hyphenated portion of a name is used as one unit; Example: Anna Smith-Meyer is filed Smithmeyer, Anna Apostrophes are not used in filing Titles, and terms of seniority, are only used to distinguish from an identical name When indexing a company, articles such as “The” and “A” are not used Example: The Mandarin Office is filed as: Mandarin Office Filing Question (3 0f 150) *A provider has an alphabetic filing system. Which of the following patients should be filed second? A. Eddie Thomas B. Elyse St. Thomas C. Mandy Thomas-Morgan D. Susie Lee Morgan-Thomas Filing Question Answer: B Filing Question (4 of 150) Which name should be filed last alphabetically? A. Steve McNair B. S. S. McNair C. Steve S. McNair D. Steve M. McNair Answer to Filing question Answer: C (Steve S. McNair) Filing Question (5 of 150) Which should be filed first numerically? A. 007 B. 7 C. 77 D. 70 Answer to Filing question Answer: B (7) RECORDS MANAGEMENT FILING *Tickler File A collection of date labeled folders used as a reminder for time-sensitive matters or other important information It’s used as a follow up method for appointments (it “tickles” you to remind you) Should be checked each day *Tickler File Question ( 6 of 150) * Which of the following is the first step a medical administrative assistant should complete when creating a tickler system to mail reminder letters? A. Check future appointments B. check patients account balances C. Verify patients insurance information D. Very names and addresses of patients Tickler File Answer Answer: A (A CMAA should check future appointments before creating a tickler file) Mail-related Medical Terms/Vocabulary Terms refresher Express Mail-the type of mail available every day of the year, including holidays, for items up to 70 lbs (pounds) in weight and 108 inches in height. First-class mail- this includes letters, post cards, postal cards, and business reply mail. Priority Mail- First-class mail that weighs more than 13 ounces Certified Mail-this type of mail gives the sender the option to receive proof of delivery. Bulk Mail- – a form of mailing large volumes of information which is presorted by zip code *Mail Question 1 (7 of 150) *A provider needs to mail two medical books weighing a total of 14 lbs to an office across the country. He wants the books to arrive in 1 week. Which of the following is the most economical delivery service to use? A. Express Mail B. Media mail C. Bulk mail D. Priority mail Answer to mail question 1 Answer: D (Priority Mail) Mail Question 2 (8 of 150) *A Medical Assistant wants to mail out 10 business letters to local doctors in the community. Which type of mail should be used? A. Priority mail B. Express mail C. Bulk mail D. First-class mail Answer to mail question 2 Answer: D (First-class mail) Medical Terms/Vocabulary Terms review *Abandonment – the discontinuation of medical care without proper notice to the patient. Arbitration – the usage of an impartial third party for the hearing and determination of a dispute. *Good Samaritan Act – states that a volunteer/CMAA is not held liable for any civil damages that may occur as a result of a health care worker’s efforts to provide first aid or any type of emergency care. This law protects physicians (doctors) and other health care workers from being sued. Question (9 of 150) *If a provider goes out of town without ensuring coverage during her absence, a patient could initiate a lawsuit on the grounds of A. abuse B. negligence C. malpractice D. abandonment Answer: D (Abandonment) Legal Terms review *Battery – the unlawful use of force or violence, or operating on someone without their consent. Assault – the threat of using force or violence. *Negligence – failure to provide the necessary care that is required. Malpractice – professional negligence; where a doctor does not perform up to standards. *Statutes – laws enacted by the legislative branch of government. Patient’s Rights *Patients’ Rights – a document developed to ensure the fairness and effectiveness of the health care system. It protects the patient and the employer. A patient has a right to confidential treatment of their medical records, and privacy concerning a medical care program. Confidentiality – information about a patient must remain private and must be shared only with other members of a patient’s health care team. (10 of 150) *When releasing confidential information, who has the right to decide how and to whom the information is communicated? A. The patient B. The provider C. The office manager D. Medical administrative assistant Answer A (the patient decides who information can be shared with) (11 of 150) * A provider did not obtain an informed consent from a coherent patient before surgery. The provider can be charged with which of the following A. Assault B. Libel C. Battery D. Negligence Answer C (Battery. This is the type that does not involve the traditional “hitting” or touching a patient associated with violence) (12 of 150) The mother of a child with flu like symptoms is checking into the doctor's office. Which of the following is the proper protocol to help prevent the spread of illness? A. Have the mother cover the child's mouth with her hand B. Demonstrate proper hand washing technique to the mother C. lead the mother and child to a designated reception area D. Direct the mother to clean the children's toys with 1:10 bleach and water solution Answer C (lead them to another reception area that is away from others) Health Insurance terms to review. You may have to do a few math questions related to deductibles and co-pays. Assignment of Benefits – authorization by an insured patient to an insurer to pay a claim directly to a third party (such as a doctor). Benefit – money paid by ins. Co. Deductible (see next slide) Copayment – small fee paid at time services are rendered by a provider; also called a copay. Policy – document detailing conditions of insurance Premium – payment made to ins. Co.; costs Waiting Period Claim – a bill submitted to an ins. Co. Deductibles and Co-payments (co-pays) review Your deductible is the amount of money you must pay for health care services before your insurance company will begin paying your medical costs. It is usually a set amount between $250 and $1,000 and it resets every year. Once you have paid off your deductible within a given year, you may only have to pay a co-payment to your doctor for a visit. This is a set amount that is due at the time of your service (doctor visit), and is usually around $20 - $25. review Allowable (allowed) charges – discounted fees that insurance companies negotiate with doctors or other providers. It’s the maximum amount an insurance company will reimburse a provider for their services. (13 of 150) Which of the following should the MAA verify when filing documents in a medical record? A. Date of birth B. billing address C. Insurance provider D. Referring physician Answer C (Insurance provider) Question ( 14 of 150) * A new patient calls the providers office and inquires about general billing policies. Which of the following is an appropriate response? A. Payment is due on the day of visit B. Your copay amount will be applied to your balance C. you will need to contact your insurance company about all financial inquiries D. We can address your question once your insurance coverage has been verified Answer D. We can address your question once your insurance coverage has been verified (15 of 150) *The total charge for today's office visit is $172, of which $146 is allowable. The patients co-payment is $20, and the $300 deductible has been met. Which of the following amounts does the patient owe for today? A. $20 B. $26 C. $128 D. $168 Answer A. ($20) (16 of 150) A patient has $50 left to meet her deductible and a 20% coinsurance. The total charge for todays services is $200. The third party payer allows $150. Which of the following amounts is the patient’s responsibility for today visit? A. $50 B. $70 C. $80 D. $150 Answer C. ($80) Medical Record Management review Creating a Medical Record- The Medical Administrative Assistant should take the following steps to establish a patients medical record: Determine the patient’s Status in the office (New or Established) Obtain the required general information Enter the information into the patients history form Review the form accuracy Enter the patient’s name into the computerized ledger Assemble the forms, prepare the folder and file as necessary (17 of 150) Which of the following is part of the check out process in a providers office? A. Asking for a valid ID B. Obtaining proof of insurance C. Reviewing the patients diagnosis D. Collecting payment from the patient Answer D (collect the payment during check-out. *Often the co-pay is paid at the beginning as the patient arrives) CMAA REVIEW What does the Acronym SOAP mean? Component of patients medical record: *SOAP APPROACH – This is a format for progress notes based on the letters of the word SOAP. S = Subjective Impressions O = Objective clinical evidence A = Assessment or Diagnosis P = Plans for further studies, treatment, or management Question on SOAP (18 of 150) *A provider (physician) sees a NP (new patient) and makes a diagnosis of anemia. Where in the progress notes would this be verified? A. Subjective B. Objective C. Assessment D. Plan Answer C (Assessment; the A represents an assessment or diagnosis) Question on SOAP (19 of 150) *A physician diagnoses a patient with a fracture and recommends physical therapy three times a week for 45 min, for 4 weeks. Where in the medical record can the MAA verify this information? A. Subjective B. Objective C. Assessment D. Plan Answer D (Plan) (20 of 150) *A patients calls the physician's office and insists on viewing his medical record after receiving an incorrect explanation of benefits(EOB). Which of the following actions should the MAA take? A. Schedule an appointment with the office manager B. Schedule an appointment with the physician C. Mail the patient his medical record D. Mail the patient a corrected EOB Answer A (schedule an appointment with the office manager to discuss the matter) Medical Record Management review Component of patients medical record: Personal and Medical History (Hx) – Created using information gathered from the patient. Usually includes information such as past illnesses, surgical operations, and the patient’s daily health habits. *Patient’s Family History – this information is just as important as the patient’s personal and medical history. Includes information regarding the health of members of the patient’s family, and a record of the causes of death. Remember, the medical records of a spouse is not important because they are not “blood relatives.” Medical Record Management Component of patients medical record: Patient’s Social History – Includes information regarding the patient’s lifestyle. Examples include smoking and drinking habits. Diagnosis (Dx)– a decision made based on the information regarding the patient’s history and the results of the doctor’s examination. Basic Telephone Techniques review Since the Medical Administrative Assistant is responsible for answering telephone calls, it is imperative to have solid communication skills. Question Have you ever called a doctors office, or spoken with a receptionist who was rude and short with you on the phone? How did it make you feel? Basic Telephone Technique(Etiquette) The following steps will ensure proper telephone etiquette Answer the telephone promptly and kindly. Be sure to properly speak into the phone Be sure to give the caller your undivided attention Speak clearly and distinctly. Always be courteous Be sure to ask the caller’s permission before placing them on hold Never allow an angry or aggressive caller to upset you; remain calm and composed Always allow the caller to hang up first. Basic Telephone Technique(Etiquette) Verbal and Non-Verbal Communication Verbal communication is the use of the language or the actual words spoken. Some of the key components of verbal communication are sounds words, speaking and language. Non-Verbal Communication is use of eye contact, body language, facial expression, or symbolic expressions to communicate a message Questions: 1. Is Texting a form of verbal or non-verbal communication? 2. How can you recognize positive non-verbal communication verses negative non-verbal communication? Basic Phone (Etiquette) Respect Respect is essential in the process of communication with co-workers, patients, and visitors. The following steps will help to create a comfortable environment: Refrain from making jokes or negative remarks that demean the abilities, skills, or aspects of co-workers Be patient and respectful when speaking with a caller that does not speak English clearly THE MEDICAL ASSISTANT’S ROLE Personal Qualities that the Medical Assistant should possess are: Dependability, Courtesy, Initiative, and Interpersonal Skills. Duties of the MAA include: Telephone coverage, scheduling, maintenance of medical records, and the management of all correspondences (communicating by exchange of letters). They may serve on committees, but may not make any final decisions or sign off on any official letters or documents. Important If you are a CMAA (MAA) and you are on the phone with a patient who is complaining of chest pain or something potentially serious, tell them to call 911 immediately! Even though you may be working in a doctor’s office, this could be a medical emergency that your office is not designed to handle. For any medical emergency, patients should always call 911. The CMAA’s role Question (21 of 150) *Which of the following is out of a MAA's regular job function (something they can’t do)? A. Approving minutes and signing letters B. Typing memos letters and reports C. Updating encounter forms and medical records D. Maintaining invoices, forms and financial statements Answer A ( A CMAA cannot sign off on letters or medical records) Medical Terms/Vocabulary Terms review Hard Copy – Computer term for a printed copy of information Inside Address –That section of a letter that contains the name and address of the person or firm to whom the letter is being sent. Example on page 858 *Wave scheduling – A certain number of patients are scheduled to arrive at the same time and patients are seen in order in which they arrive. *Modified Wave scheduling – Small groups of patients are scheduled at intervals throughout the hour. Scheduling question (22 of 150) *Which of the following is most likely to result in adequate patient flow A. Rescheduled appointments B. Emergency appointments C. Wave schedule D. Double booking Answer: C (Wave Schedule) (23 of 150) Which of the following is the first step in helping a patient remember a follow-up appointment? A. Call the patient as a reminder B. Mail the patient a reminder card C. Hand the patient a reminder card D. Have the patient confirm the appointment Answer C (Handing a patient an appointment card is the first thing you should do after making a follow-up appointment) (24 of 150) *During a call with a patient who is scheduled for a provider visit, the MAA should end the conversation with which of the following? A. Insurance verification B. The patients address C. Social Security number D. Appointment confirmation Answer D (Appointment verification) Question (25 of 150) *A patient calls and cancels an appointment with less than 24 hr notice. Which of the following actions should the MAA take? A. Call other patients who have not been seen recently if they would like to make an appointment B. Extend the time allowed for other appointments so that the providers time is evenly distributed C. Call patients scheduled for later in the day and ask if they would like to be seen earlier D. Place the patient on hold and follow up with the office manager Answer C. Call patients scheduled for later in the day and ask if they would like to be seen earlier Medical Terms/Vocabulary Terms Double booking – Scheduling two patients to see the doctor at the same time. NP = new patient *Block Letter Style- Letter format in which all parts of the letter start at the left margin *Modified Block letter style - Letter-writing format in which all parts of the letter start at the left margin except the heading, complimentary closing, signature, and title, which starts at the center. Examples in Simmers book. Addressing a letter properly (26 of 150) Which of the following is appropriate when addressing a business letter? A. Dear Doctor Jones B. Dear Dr. Jones, MD C. Dear Robert Jones, MD D. Dear Doctor Robert Jones E. None of the above Answer on next slide Answer Answer: A (Dear Doctor Jones; or Dear Dr. Jones would be acceptable as well) (27 of 150) *Which of the following is a characteristic of a blockstyle letter? A. Salutation is flush left B. Body of letter is double spaced C. Typed signature begins in the center D. First line of paragraph is indent five spaces A. Salutation is flush left The CMAA’s role and limitations (28 of 150) *Which of the following is an example of an appropriate interaction between a patient and a medical administrative assistant in the reception area? A. Offer to educate a family member of the patient about a diagnosis or procedure B. Be supportive and share a similar experience with the patient C. After the appointment, explain directions to the patient for any prescribed medications D. After the patient has signed in remove the patients name from view on sign-in sheet Answer Answer: D (this is the only option; the other options would be acceptable for medical professionals only) Question (29 of 150) *After the MAA composes a business letter, under which of the following circumstances must the physician sign the letter? A. Letters to colleagues or offices of a medical society B. Notifications to patients C. Letters of solicitation D. Letters arranging or rescheduling appointments for patients A. Letters to colleagues or offices of a medical society CEUs Continuing Education for the CMAA: Like most professions, the medical assistant must stay current by taking special courses throughout the year. This will allow a CMAA to stay certified without having to take the certification exam over and over again every two years. CEUs, or Continuing Education Units, are the best way to stay current. These units are obtained throughout the year by attending special workshops or trainings. Each workshop will give you a certain number of CEUS, and you will need to accumulate a set amount every couple of years to maintain your certification. Question ( 30 of 150) Which of the following must MAA's do in order to keep their certification current? A. Attend staff meetings B. Submit CEU's C. Publish an article D. Retest annually Answer B (Submit CEUs. This is a better alternative rather than retesting) New Patient question (31 of 150) *A new patient is inquiring about office policies and procedures. Which of the following is an appropriate response from the medical administrative assistant? A. "Here is a copy of our policies and procedures" B. "The nurse will provide you with policies and procedures in the exam room" C. "I will provide you with a detailed list of policies and procedures after your visit today" D. Per HIPAA regulations, you must sign a release before receiving our policies and procedures" See next slide for answer Answer Answer: A (The CMAA can give a copy of the policies and procedures to a patient as requested by the patient. They may not discuss any medical concerns or answer any medically-related questions with patient.) (32 of 150) *Where should completed medical record request be kept? A. In the patients chart B. In a separate marked file C. In the tickler file D. With the insurance company Answer A (in the patient’s chart) (33 of 150) *A MAA calls a 17 year old patient by only her last name in the reception area to provide additional contact information. Which of the following is the reason the assistant calls for the patient in this way? A. The patient is a minor B. It prevents disclosure C. It is improper to call a patient by her first name D. It is a HIPAA violation to address the patient by her first name Answer B. It prevents disclosure of personal information. The least amount of information should always be disclosed, or said aloud, when others are around.