Your FREE CMAA Flashcards 2026 – 200+ Cards

Communication using active listening, empathy, open-ended questions, and matching nonverbal cues to make a patient feel heard.

Fully focusing on the speaker, reflecting and clarifying, rather than just waiting to respond.

A question that invites a full response ('How are you feeling?') rather than a yes/no answer.

Behaviors that shut down communication: false reassurance, judging, interrupting, and changing the subject.

Messages sent by tone, facial expression, eye contact, posture, and gestures — much of meaning is nonverbal.

Stay calm, listen without interrupting, acknowledge the feeling, move to a private area, focus on solutions, and escalate if needed.

Understanding and acknowledging another person's feelings; central to patient relations.

Answer promptly (by the third ring), identify the office and yourself, and speak clearly.

Sorting calls by urgency so emergencies and clinical issues are routed first.

Who called, what about, a callback number, the date/time, and the taker's initials.

Verify the caller's identity and authority to receive the information.

Delivering respectful, individualized care across patients' languages, beliefs, and backgrounds.

A qualified medical interpreter — not a family member or child — to ensure accuracy and confidentiality.

Appearance, punctuality, reliability, confidentiality, and a respectful, courteous manner.

Understanding each role's scope of practice and communicating clearly with clear handoffs.

Follow the office protocol to get help immediately — never place an emergency caller on hold to finish another task.

Accurate, professional, and HIPAA-compliant correspondence (letters, emails, secure messages).

An unconscious coping response (denial, projection, regression) a patient may use under stress.

Sympathy is feeling sorry for someone; empathy is understanding and sharing their feelings — empathy is therapeutic.

Mismatched words and body language confuse the patient; consistency builds trust.

Ask permission, wait for the answer, check back periodically, and thank them — never leave an emergency on hold.

To protect accuracy and confidentiality in medical conversations.

Communication & Professionalism and Patient Encounter, tied at 21 scored items each.

The front desk — the CMAA's greeting, professionalism, and efficiency set the tone.

The patient's identifying and contact information collected at registration — name, DOB, address, insurance.

Demographics, insurance card (both sides), photo ID, required signatures, and the copayment.

Most claim denials start with a wrong name, date of birth, or policy number — accurate registration produces a clean claim.

A secure, real-time digital version of a patient's chart that authorized users can access and share across providers.

An EMR is a single practice's digital chart; an EHR is designed to be shared across providers and settings.

A progress-note format: Subjective (patient reports), Objective (findings), Assessment (diagnosis), Plan (treatment).

The running list of a patient's active diagnoses and conditions kept in the chart.

Draw a single line through it (leaving it legible), write the correction, then date and initial — never erase or white out.

Add a dated, signed addendum — you never delete or overwrite the original entry.

To confirm active coverage, effective dates, copay/deductible amounts, and whether a referral or authorization is needed — preventing denials.

The patient's authorization for the payer to pay the provider directly.

Greet the patient, verify/update demographics and insurance, scan ID and card, obtain signatures, and collect the copay.

Schedule any follow-up, complete the encounter form, collect any balance, and provide instructions or referrals.

The rules that decide which plan pays first when a patient is covered by more than one.

A COB rule: for a dependent child, the plan of the parent whose birthday falls earlier in the year pays first.

Acknowledgement of the Notice of Privacy Practices, consent to treat, and assignment of benefits.

The state- and payer-required period a medical record must be kept before secure destruction; varies, longer for minors.

Demographics, history/problem list, progress (SOAP) notes, results/reports, consents/authorizations, and correspondence.

So the most recent information is on top and quickly accessible to the care team.

Active records are for current patients; inactive (or closed) records are for those not seen recently and may be archived.

It is accurate, complete, timely, legible, and confidential, with corrections made properly.

Under HIPAA, patients have the right to obtain a copy of their own medical records.

An Advance Beneficiary Notice (ABN, CMS-R-131), so the patient can accept financial responsibility.

Electronic health record.

Coordination of benefits.

Assignment of benefits.

Most denials trace to front-end coverage and data errors, which verification catches before the visit.

The Health Insurance Portability and Accountability Act, which protects health information through its Privacy and Security Rules.

Any individually identifiable health information that links a person to their health, care, or payment.

The HIPAA rule that staff use, disclose, or request only the least PHI needed to accomplish a purpose.

The everyday uses of PHI that HIPAA permits without separate patient authorization.

For most uses beyond treatment, payment, and operations — for example, marketing.

The law that strengthened HIPAA enforcement and added breach-notification requirements.

The Privacy Rule governs how PHI is used and disclosed; the Security Rule sets safeguards for electronic PHI (ePHI).

The document describing how a practice uses and protects PHI; patients acknowledge receiving it.

A patient's voluntary, documented agreement to treatment after being told the risks, benefits, and alternatives.

Consent inferred from a patient's actions (rolling up a sleeve) or assumed in a true emergency.

A patient-signed authorization required to disclose medical records to a third party.

Generally a parent or legal guardian, with state-specific exceptions (e.g., emancipated minors, certain services).

The level of care a reasonably prudent worker would provide under similar circumstances; the liability benchmark.

The duties a credentialed worker is legally permitted to perform; acting outside it is a liability risk.

Failure to meet the standard of care that results in harm to the patient.

Knowingly and intentionally submitting false claims for payment — e.g., billing for services not rendered.

Improper practice that causes unnecessary cost, without the proven intent to deceive.

Intent: fraud requires knowing deceit; abuse is improper but without proven intent.

The ethical principle of acting for the patient's good.

The ethical principle of avoiding harm to the patient.

The duty to keep patient information private and disclose it only as permitted or authorized.

A legal order requiring records (e.g., a patient's chart) to be produced for a court proceeding.

A document stating a patient's wishes for care if they become unable to decide (e.g., living will, durable power of attorney).

An office's written policies and training designed to prevent and detect legal and billing violations.

The HITECH requirement to notify patients (and sometimes HHS) when unsecured PHI is breached.

An internal document of an unusual event or error; it is risk-management documentation, not part of the medical record.

Notice of Privacy Practices.

Release of information.

Protected health information.

A signed release of information (ROI) authorization.

Confirm the correct recipient and number, use a confidentiality cover sheet, and verify the authorization to release.

The framework set up in the schedule that blocks out times a provider is unavailable (lunch, meetings, vacations) before any patients are booked.

Time-specified scheduling — each patient gets a set appointment time and slot length. The most common system.

Several patients are booked at the top of the hour and seen in the order they arrive, smoothing out late arrivals and no-shows.

A blend of wave and stream: two or three patients at the start of each half-hour, then single slots.

Scheduling two patients in the same time slot, used for short visits or when one may not need the full time.

Grouping similar appointments together (e.g., all physicals on Tuesday mornings) for efficiency.

Patients arrive within posted hours with no set time (walk-in clinics) — first come, first served.

Build the matrix — block off the provider's unavailable time — then schedule patients only into the open slots.

A patient who misses an appointment without canceling; tracked and documented per office policy.

A primary-care provider's authorization for a patient to see a specialist; usually required by HMO plans.

A payer's approval that must be obtained before certain services or drugs, or the claim is denied.

A referral routes a patient to a specialist (often HMO-required); a prior authorization is the payer approving a specific service in advance.

Reminder calls, texts, and emails before the appointment; document missed visits per policy.

A system that brings patients back for needed follow-up visits and screenings.

New patients require registration, a full history, and insurance verification, which take more time than an established quick recheck.

An urgent or same-day visit fit into the day's open or wave slots.

Open time built into the schedule to absorb work-ins, emergencies, and running behind.

A reminder/follow-up filing system organized by date to track tasks like recalls and pending items.

Patient contact info, the reason/visit type, the correct slot length, and any prep instructions (fasting, arrive early).

A patient who has received care from the practice (or provider group) within the past three years.

A patient who has not received care from the practice (or provider group) within the past three years.

A cancellation is when the patient notifies the office in advance; a no-show is missing the appointment without notice.

For short visits or quick rechecks, where both patients can reasonably be seen in the same slot.

Provider unavailable time: lunch, meetings, hospital rounds, vacations, and holidays.

To prevent booking patients into time the provider is unavailable, keeping the schedule realistic.

The Occupational Safety and Health Administration, which sets workplace-safety standards protecting medical-office staff.

OSHA protects employees' safety; HIPAA protects patients' health information.

The OSHA rule requiring exposure-control plans, PPE, and safe sharps handling.

The OSHA rule requiring Safety Data Sheets (SDS) and labeling for hazardous chemicals.

The document describing a hazardous chemical's handling, hazards, and first aid.

Gloves, gowns, masks, and eye protection used to protect staff from exposure.

Treating all blood and body fluids as potentially infectious; the baseline of infection control.

Handwashing or alcohol-based hand rub — the single most effective infection-control measure.

Tracking supplies on hand, setting reorder points, and verifying deliveries to prevent stockouts.

Match the delivery against the packing slip and the invoice (items and quantities) before signing or paying.

A packing slip lists what was shipped; an invoice is the bill requesting payment.

Set by state law and payer rules; varies, and is longer for minors (until majority plus added years).

Securely — shredding paper and wiping or destroying electronic media.

Alphabetic, numeric, or subject filing — they must be consistent and confidential.

Filing records by last name, then first name and middle initial.

Filing records by an assigned number; adds privacy and works well for large practices.

A small cash fund for minor office expenses, reconciled and documented per policy.

Money the practice owes to vendors and suppliers.

Money owed to the practice by patients and payers.

Plans and procedures for fire, evacuation, and medical emergencies; staff know the codes and keep exits clear.

Routines that secure the building and PHI and prepare or shut down the office each day.

A record of service and repairs that keeps office equipment safe and operational.

Categories like first-class, certified, and registered mail, chosen by speed, cost, and proof-of-delivery needs.

Mail that provides proof of mailing and delivery — used for important or legal correspondence.

Backups (for EHR), off-site storage or fire-resistant storage, and a records-recovery plan.

Safety Data Sheet.

Personal protective equipment.

OSHA standards — the Bloodborne Pathogens and Hazard Communication standards.

The financial process of a patient encounter from scheduling and registration through coding, claims, and payment.

The document recording the diagnoses and services from a visit; the source document for the claim.

The U.S. code set for reporting diagnoses — the reason for the encounter (the 'why').

Current Procedural Terminology — the AMA code set for physician and outpatient procedures and services (the 'what').

Codes for supplies, drugs, equipment, and services not covered by CPT.

The principle that the diagnosis must support the procedure billed; payers deny services without it.

The standard claim form used by physicians and other non-institutional (professional) providers.

The institutional claim form used by hospitals and facilities.

CMS-1500 = professional/physician claims; UB-04 = institutional/hospital claims.

A service that validates, reformats, and routes electronic claims to the correct payer.

A claim with no errors that passes edits and can be paid on the first submission.

A fixed dollar amount the patient pays for a covered service at the time of care.

The amount a patient must pay out of pocket each year before the plan begins to pay.

The percentage of a covered service's cost the patient pays after meeting the deductible.

Copay is a flat fee per service; coinsurance is a percentage after the deductible; the deductible comes first.

The cap on a patient's yearly cost share, after which the plan pays 100%.

The statement a payer sends the provider explaining how each claim line was paid, adjusted, or denied.

The statement a payer sends the patient showing how a claim was processed; it is not a bill.

A rejection never entered the payer's system (fix and resubmit); a denial was processed and refused (correct and appeal).

A notice (CMS-R-131) telling a Medicare patient a service may be denied so they can accept responsibility.

The patient's share of cost: copay + deductible + coinsurance, up to the out-of-pocket maximum.

A reimbursement model that pays the provider for each individual service rendered.

A reimbursement model paying a fixed amount per member per month regardless of services used.

At check-in, once benefits are confirmed.

The Fair Debt Collection Practices Act, which governs how patient balances may be collected.

Explanation of benefits.

Advance Beneficiary Notice of Noncoverage.

Current Procedural Terminology.

International Classification of Diseases, 10th Revision, Clinical Modification.

Healthcare Common Procedure Coding System.

Durable medical equipment.

The encounter form (superbill) completed at the visit.

No errors or missing information, so it passes edits and is paid on the first submission.

Care for a patient formally admitted to a hospital or facility for an overnight or longer stay.

Care provided without an overnight admission — physician offices, clinics, urgent care, same-day surgery.

'Admitted.' No admission means outpatient, even for same-day surgery.

The word part at the beginning of a medical term, often indicating position, number, or negation (hyper-, hypo-, a-).

The core part of a medical term that names the body part or system (cardi/o = heart).

The word part at the end of a medical term, often naming a condition or procedure (-itis, -ectomy).

Suffix meaning inflammation (e.g., dermatitis = inflammation of the skin).

Suffix meaning surgical removal (e.g., appendectomy = removal of the appendix).

Suffix meaning the study of (e.g., cardiology = the study of the heart).

hyper- means above/excessive (hypertension); hypo- means below/deficient (hypoglycemia).

Root meaning heart (cardiology, carditis).

Root meaning skin (dermatology, dermatitis).

Root meaning stomach (gastritis, gastroenterology).

The doctor (MD/DO) who diagnoses and directs the patient's care.

A licensed provider who practices medicine under physician supervision.

An advanced-practice nurse who can assess, diagnose, and prescribe within scope.

Health Maintenance Organization — a managed-care plan requiring in-network care and usually a referral.

Preferred Provider Organization — a plan allowing out-of-network care without a referral at higher cost.

HMO: in-network only, PCP referral required, lower cost. PPO: out-of-network allowed, no referral, higher cost.

The federal program for people 65+ and certain others: Part A (hospital), B (medical), C (Advantage), D (drugs).

Part A covers inpatient hospital and facility care; Part B covers physician, outpatient, and DME services.

The joint federal-state program for low-income individuals; generally the payer of last resort.

The federal health program for active-duty and retired military members and their families.

Commercial/managed care, government programs, and other third-party liability (workers' comp, auto).

A liability payer covering work-related injuries and illnesses, with its own forms and rules.

Spaces that hold organs — e.g., the thoracic (chest) and abdominopelvic cavities.

Standing erect, facing forward, arms at the sides with palms forward — the reference for directional terms.

Anterior (ventral) = front of the body; posterior (dorsal) = back of the body.

Proximal = nearer the point of attachment/trunk; distal = farther from it.

Superior = toward the head/upper; inferior = toward the feet/lower.

Medial = toward the midline; lateral = away from the midline.

Temperature, pulse, respiration, and blood pressure (and often pulse-oximetry and pain) — clinical staff record them.

A physician who specializes in the heart and cardiovascular system.

A physician who specializes in skin conditions.

A physician who specializes in the musculoskeletal system (bones, joints, muscles).

A physician who specializes in the care of infants and children.

A physician who specializes in pregnancy/childbirth (obstetrics) and the female reproductive system (gynecology).

The main provider managing a patient's overall care, often the gatekeeper for referrals in an HMO.

Nothing by mouth (nil per os) — the patient should not eat or drink, often before a procedure.

Immediately / right away.

As needed (pro re nata).

Prescription or treatment.

History.

Diagnosis.

Treatment.

Symptoms (or surgery, by context).

Date of birth.

Health Maintenance Organization.

Preferred Provider Organization.

Primary care provider.

Physician assistant.

Nurse practitioner.