AMT CMAS Certified Medical Administrative Specialist

A patient says, 'I have hepatomegaly.' Which body system is affected?

• AKidneys
• BLiver
• CSpleen
• DStomach

Which abbreviation appears on The Joint Commission 'Do Not Use' list and should never be used in patient records?

• Amg
• BmL
• CQD
• Dbid

A note states a patient is scheduled for a 'cholecystectomy.' This is the surgical removal of the:

• AGallbladder
• BAppendix
• CUterus
• DColon

Which medical specialist primarily treats disorders of the endocrine system?

• ANephrologist
• BEndocrinologist
• CGastroenterologist
• DHematologist

The prefix 'tachy-' means:

• ASlow
• BFast
• CWithout
• DDifficult

Which task is OUTSIDE the scope of a CMAS, who performs front-office administrative work?

• AVerifying insurance eligibility
• BDrawing a venipuncture blood sample
• CPosting payments to patient accounts
• DScheduling a follow-up appointment

An angry patient is yelling at the front desk because their appointment is running 45 minutes late. The BEST initial response is to:

• ATell them to lower their voice or leave
• BAcknowledge the frustration, apologize for the wait, and offer an update
• CWalk away to find the office manager
• DExplain that emergencies always take priority and they must wait

A patient calls and says, 'I'm having crushing chest pain radiating down my left arm.' The CMAS should:

• ASchedule the next available same-day appointment
• BPlace the caller on hold and find the physician
• CTell the caller to hang up and call 911 immediately, stay on the line
• DTake a message and have the nurse call back within 30 minutes

A deaf patient arrives for an appointment. Under the ADA, the practice must:

• ACharge the patient extra for any interpreter services
• BProvide effective communication, which may include a qualified sign language interpreter,…
• CRefuse the appointment if no interpreter is on staff
• DRequire the patient to bring a family member to translate

Which behavior best demonstrates cultural sensitivity at the front desk?

• AAssuming a patient's preferred name based on their last name
• BAsking 'How would you like to be addressed?' during check-in
• CSpeaking louder when a patient has limited English
• DRecommending the patient bring an English-speaking friend next time

Which scheduling method assigns each patient a unique time slot equal to the expected visit length and is most common for established practices wanting predictable flow?

• AWave scheduling
• BModified wave scheduling
• CStream (single-booking) scheduling
• DOpen-hours (walk-in) scheduling

A practice books 4 patients at 9:00, 4 at 10:00, and 4 at 11:00, seeing them in arrival order. This is:

• AStream scheduling
• BWave scheduling
• CCluster scheduling
• DDouble booking

A no-show patient missed a follow-up. The CMAS should:

• ACharge the patient's credit card automatically without notice
• BDocument the missed appointment in the chart and follow the practice's no-show/recall pol…
• CDischarge the patient from the practice immediately
• DSchedule them for a same-day slot tomorrow without contacting them

A managed care plan requires that the primary care physician (PCP) authorize specialist visits. This PCP role is called:

• AIndemnity model
• BGatekeeper
• CCapitation
• DFee schedule

An MRI of the lumbar spine requires prior authorization from the insurer before scheduling. If the CMAS schedules the MRI without authorization, the MOST likely consequence is:

• AHigher reimbursement from the insurer
• BClaim denial and the patient or practice owing the full charge
• CAutomatic Medicare coverage as a courtesy
• DAn audit by the FDA

A SOAP note's 'O' section contains:

• AObjective data such as vitals and exam findings
• BThe patient's chief complaint in their own words
• CThe diagnosis and treatment plan
• DOutpatient billing codes

The Problem-Oriented Medical Record (POMR) organizes the chart by:

• ADate of service only
• BA master problem list, with each problem tracked across visits
• CProvider name
• DInsurance plan

A provider realizes they forgot to document a finding from yesterday's visit. The correct action is to:

• AEdit yesterday's note in place without indicating a change
• BAdd a clearly labeled late entry / addendum with today's date and signature
• CDiscard the original note and rewrite it
• DHave the CMAS write the addition under the provider's name

Federal Medicare rules require providers to retain medical records for at least:

• A1 year
• B3 years
• C5 years (7 for managed care contracts)
• DIndefinitely with no minimum

Under HIPAA, a release of information (ROI) authorization must include all of the following EXCEPT:

• ASpecific information to be disclosed
• BRecipient of the disclosure
• CExpiration date or event
• DThe patient's medical diagnosis

The federal program that replaced Meaningful Use and incentivizes EHR adoption and data exchange is now called:

• AMedicare Modernization
• BPromoting Interoperability (PI)
• CMeaningful Use Stage 4
• DHITECH Reauthorization

Medicare Part A primarily covers:

• AOutpatient physician services
• BInpatient hospital, skilled nursing, hospice, and some home health
• CPrescription drugs
• DRoutine dental and vision care

Medicare Part B primarily covers:

• AInpatient hospital stays
• BOutpatient physician services, preventive care, and durable medical equipment
• CPrescription drugs picked up at a retail pharmacy
• DLong-term custodial care

The Medicare Beneficiary Identifier (MBI) replaced what older identifier in 2018-2019?

• AThe Social Security Number-based HICN
• BThe Tax Identification Number
• CThe NPI
• DThe Medicaid recipient number

An Advance Beneficiary Notice of Noncoverage (ABN) is given to a Medicare patient when:

• AEvery visit, regardless of coverage
• BThe provider believes Medicare will likely deny the service as not medically necessary
• COnly for emergency services
• DAfter Medicare has already denied the claim

The standard paper claim form used by physicians and non-institutional providers is:

• AUB-04
• BCMS-1500
• CADA Dental Claim Form
• DCMS-1490S

On the CMS-1500 form, Box 21 (Diagnosis or Nature of Illness) accepts which code set?

• ACPT codes
• BHCPCS Level II codes
• CICD-10-CM diagnosis codes
• DNDC drug codes

ICD-10-CM codes are used to report:

• AProcedures performed in the outpatient setting
• BDiagnoses, signs, symptoms, and reasons for the encounter
• CDurable medical equipment
• DInpatient hospital procedures

Which code set reports outpatient physician procedures and services (e.g., office visit 99213)?

• AICD-10-CM
• BICD-10-PCS
• CCPT
• DNDC

HCPCS Level II codes (e.g., E0114 for crutches) primarily cover:

• APhysician E/M visits
• BInpatient hospital procedures
• CDurable medical equipment, supplies, drugs administered, and ambulance services
• DMental health diagnoses

An NPI (National Provider Identifier) is:

• AA 10-digit unique identifier assigned to providers under HIPAA
• BA 9-digit IRS tax number
• CAn optional ID used only for Medicaid
• DA state license number

An EOB (Explanation of Benefits) is sent by the:

• AProvider to the patient
• BInsurance payer to the patient (and provider receives the ERA)
• CClearinghouse to the IRS
• DPatient to the provider

The HIPAA standard transaction for electronic claim submission from provider to payer is:

• A270/271
• B835
• C837
• D276/277

A clearinghouse's primary function in claim submission is to:

• AAssign diagnosis codes for the provider
• BScrub claims for formatting errors and route them to the correct payer
• CDecide which services are medically necessary
• DPay the provider directly

An AR aging report typically buckets unpaid claims by 30, 60, 90, and 120+ days. The OLDEST bucket should be worked first because:

• AOlder claims pay more interest
• BThe older a claim is, the less likely it will be collected
• CPayers always pay 120+ day claims automatically
• DOlder claims do not require follow-up

A claim is denied with reason code CO-50 ('not deemed medically necessary'). The most appropriate first step is to:

• AWrite the balance off immediately
• BBill the patient the full charge
• CReview documentation, check the LCD/NCD, and file an appeal if warranted
• DSubmit the same claim again unchanged

Tricare is the federal health program for:

• ALow-income families
• BActive-duty service members, retirees, and their dependents
• CFederal employees only
• DNative American tribes

Workers' compensation claims are typically billed to:

• AThe patient's primary medical insurance
• BThe employer's workers' compensation carrier
• CMedicare regardless of employment status
• DThe state Medicaid agency

A patient's plan has a $1,500 deductible, 20% coinsurance, and a $30 specialist copay. They have met $500 of the deductible. For a $200 specialist office visit, the patient owes (at minimum):

• A$30 copay only
• B$200 (the entire allowed amount, until deductible met)
• C$40 (20% of $200)
• D$170

A sliding fee scale (SFS) at a community health center adjusts:

• AProvider salaries based on volume
• BPatient charges based on family income and household size
• CInsurance premiums for Medicaid
• DPharmacy copays for all patients

The HIPAA Privacy Rule is codified at:

• A21 CFR Part 11
• B42 CFR Part 2
• C45 CFR Parts 160 and 164
• D29 CFR 1910

Under HIPAA, disclosures for treatment, payment, and healthcare operations (TPO):

• AAlways require written patient authorization
• BGenerally do NOT require patient authorization, though minimum necessary still applies fo…
• CAre prohibited entirely
• DRequire notarized consent