2026-2027 CMAA Study Guide (7pages)

wave scheduling - Patients are scheduled at the same time each hour to create short term flexibility each hour modified-wave scheduling - a scheduling system similar to the wave system, with patients arriving at planned intervals during the hour, allowing time to catch up before the next hour begins -scheduling two patients to come at 9 am and on at 9:30 am -scheduling patients to arrive at given intervals during the first half of the hour and none for the second half cluster booking - booking a number of patients who have specific needs together at the same time of day -a physicians only offering examinations on tuesdays and thursday mornings double booking scheduling - two patients are scheduled to come at the same time to see the same physician stream scheduling - scheduling patients for specific times at regular intervals -time allotted depends on the reason for the visit open hours scheduling - patients are not scheduled for a specific time, but told to come in at intermittent times -seen in the order in which they arrive Medicare - federally funded health insurance provided to people age 65 or older, people younger than 65 who have certain disabilities, and people of all ages with end-stage kidney disease -only funded by federal government Medicaid - a government-based health insurance option that pays for medical assistance for individuals who have low incomes and limited financial resources. Funded at the state and national level -administered at the state level -funded by state and federal government Explanation of Benefits (EOB) - a record of a patient's fees Advance Beneficiary Notice (ABN) - tells you if Medicare may not cover a service GERD - gastroesophageal reflux disease -stomach condition petty cash fund - used to make small payments Health Maintenance Organization (HMO) - plan that allows patients to only go to physicians, other health care professionals, or hospitals on a list of approved providers, except in an emergency -fixed payments Preferred Provider Organization (PPO) - plan that allows patients to use physicians, specialists, and hospitals in the plan's network and receive a greater discount on services coinsurance - form of cost-sharing that kicks in after the deductible is met -percentage patient pays Medicare Part A - cover hospitalization insurance -"AHH I have to go to the hospital" (AHH= Part A)3 Medicare Part B - helps pay for physician's services, other medical professional's services, medical services, medical-surgical supplies not covered by Part A -"Oh Boy I have to go the doctor" (Boy= Part B) Medicare Part C - Medicare Advantage (MA) -combined package of benefits under Medicare Parts A and B that may offer extra coverage for services -ex:vision, hearing, dental, health, and wellness Medicare Part D - a plan run by private insurance medical insurance companies and other vendors approved by Medicare to cover the cost of approved prescriptions -part D= drugs