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AMT CMAS practice questions

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Question 1Medical Office Administration

A patient's insurance policy lists a $25 copay for office visits and an annual deductible of $1,000 that has not yet been met. Which amount is the practice most likely to collect at the time of the visit?

  1. The $1,000 deductible
  2. Nothing until the claim adjudicates
  3. The $25 copay only Correct answer.
  4. The full visit charge

Explanation

A copay is a fixed patient payment typically due at the time of service regardless of deductible status. Collecting the full charge or the entire deductible up front is not standard front-desk practice, and deferring all collection until adjudication ignores the copay obligation.

Question 2Medical Office Administration

Which document authorizes a provider to release a patient's protected health information to a specified third party?

  1. An advance beneficiary notice
  2. A signed authorization form Correct answer.
  3. A superbill
  4. An assignment of benefits

Explanation

A valid written authorization permits disclosure of protected health information for purposes outside treatment, payment, and operations. An ABN addresses Medicare billing liability, a superbill supports claim submission, and an assignment of benefits directs payment to the provider.

Question 3Medical Office Administration

A new patient calls to schedule a first visit and reports a high-deductible plan. Which information is most important to verify before the appointment is booked?

  1. Eligibility and active coverage dates Correct answer.
  2. The patient's preferred pharmacy
  3. The patient's employer address
  4. The referring physician's NPI

Explanation

Confirming that coverage is active on the date of service prevents denials and establishes the patient's financial responsibility. Employer address, pharmacy preference, and referring provider identifiers do not determine whether the visit will be covered.

Question 4Medical Office Administration

Which scheduling approach reserves specific daily time slots for urgent or same-day visits?

  1. Block scheduling
  2. Wave scheduling
  3. Matrix scheduling
  4. Open-access scheduling Correct answer.

Explanation

Open-access scheduling holds capacity open each day so patients with acute needs can be seen promptly. Wave and block methods organize appointment flow differently, and matrix scheduling templates recurring slot patterns rather than protecting same-day capacity.

Question 5Medical Office Administration

A patient arrives for a follow-up and states their insurance changed since the last visit. What is the appropriate first step?

  1. Collect the new card and update the record before the encounter Correct answer.
  2. Bill the visit to the previous insurer
  3. Reschedule the visit for a later date
  4. Ask the patient to mail the card after the visit

Explanation

Updating demographic and insurance data at check-in ensures the claim is routed to the correct payer and reflects current cost-sharing. Billing the old insurer or delaying data capture creates denials and rework, and rescheduling is unnecessary when the card can be captured now.

Question 6Medical Office Administration

Under Medicare rules, a patient must be given written notice before receiving a service that the practice expects Medicare will not cover. Which form serves this purpose?

  1. Advance beneficiary notice Correct answer.
  2. Notice of privacy practices
  3. Consent for treatment
  4. Explanation of benefits

Explanation

An advance beneficiary notice informs the patient in advance that Medicare may deny payment so the patient can decide whether to proceed and accept financial responsibility. Privacy notices, consent forms, and EOBs serve unrelated functions.

Question 7Medical Office Administration

Which identifier is used on claims to report the diagnosis codes for a visit?

  1. Revenue codes
  2. CPT codes
  3. ICD-10-CM codes Correct answer.
  4. HCPCS Level II codes

Explanation

ICD-10-CM codes describe diagnoses and the medical necessity for services. CPT and HCPCS Level II codes report procedures and supplies, and revenue codes classify facility billing categories.

Question 8Medical Office Administration

A patient's account shows a $120 balance. The patient pays $40 at check-in. What is the remaining balance?

  1. $120
  2. $80 Correct answer.
  3. $40
  4. $160

Explanation

Subtracting the payment received from the outstanding balance yields the amount still owed. Recording the full prior balance or adding the payment would misstate the account.

Question 9Medical Office Administration

Which action best protects the practice when a patient repeatedly misses scheduled appointments?

  1. Refusing to schedule the patient again without notice
  2. Charging a fee only to patients with commercial insurance
  3. Posting the patient's name in the waiting area
  4. Applying a documented missed-appointment policy consistently Correct answer.

Explanation

A written policy applied consistently to all patients supports fair enforcement and reduces legal risk. Selective fees or public identification of patients create discrimination and privacy problems, and blanket refusal without notice is inappropriate.

Question 10Medical Office Administration

Which element is required for a claim to be considered clean on first submission?

  1. A copy of the patient's photo identification
  2. The patient's preferred contact method
  3. Accurate patient, provider, and payer information Correct answer.
  4. A patient signature on the superbill

Explanation

A clean claim contains complete and accurate data needed for adjudication, including patient, provider, and payer details with correct codes. Photo identification and contact preferences are not claim data elements, and superbill signatures are not universally required.

Question 11Medical Office Administration

A patient requests a copy of their medical record. Which response follows standard practice?

  1. Release the record only to another physician
  2. Provide the record without documenting the request
  3. Provide the record after a signed request and applicable fee Correct answer.
  4. Deny the request because records belong to the practice

Explanation

Patients generally have a right to access their records upon written request, with permitted fees and documentation of the disclosure. Denying access or releasing records only to other providers conflicts with patient access rights, and failing to document the release undermines the audit trail.

Question 12Medical Office Administration

Which practice best supports compliance with the minimum necessary standard?

  1. Limiting access to information needed for the task Correct answer.
  2. Sharing full records with all staff by default
  3. Storing records only on personal devices
  4. Emailing records to any requesting party

Explanation

The minimum necessary standard requires limiting uses and disclosures to the least information needed to accomplish the purpose. Broad default access, unrestricted emailing, and personal-device storage all increase inappropriate disclosure risk.

Question 13Medical Office Administration

A claim is denied because the service requires prior authorization that was never obtained. What is the most appropriate next step?

  1. Bill the patient without any explanation
  2. Investigate whether retroactive authorization is possible Correct answer.
  3. Write off the balance immediately
  4. Resubmit the identical claim

Explanation

When a denial cites missing authorization, the practice should determine whether the payer allows retroactive approval or an appeal before assigning financial responsibility. Resubmitting unchanged data will fail again, and writing off or billing the patient prematurely may be inappropriate.

Question 14Medical Office Administration

Which financial report summarizes charges, payments, and adjustments over a defined period?

  1. Patient ledger
  2. Day sheet Correct answer.
  3. Encounter form
  4. Aging report

Explanation

A day sheet, or daily journal, captures the charges, payments, and adjustments posted during a given day or period. Aging reports track outstanding balances, patient ledgers show one account's history, and encounter forms capture clinical and coding data.

Question 15Medical Office Administration

A patient with two insurance plans has a claim. Which plan is generally billed first?

  1. The plan the patient has held longer
  2. The primary plan as determined by coordination of benefits rules Correct answer.
  3. The plan chosen by the provider
  4. The plan with the lower premium

Explanation

Coordination of benefits rules, often including birthday rules or Medicare secondary payer rules, determine which plan is primary. Premium cost, tenure, and provider preference do not establish primacy.

Question 16Medical Office Administration

Which item is typically included in a patient registration packet?

  1. Demographic and insurance information forms Correct answer.
  2. The provider's malpractice policy
  3. The practice's marketing brochure
  4. The office's vendor contracts

Explanation

Registration packets gather the demographic, insurance, and consent information needed to establish the patient record and bill correctly. Marketing materials, malpractice policies, and vendor contracts are internal or promotional documents not required for registration.

Question 17Medical Office Administration

A provider asks staff to post patient names on a whiteboard to track who is in the waiting room. What is the best response?

  1. Post only the patients' diagnoses
  2. Comply because the board is inside the office
  3. Post names only for patients who consent verbally
  4. Suggest a method that does not display identifiable information Correct answer.

Explanation

Displaying identifiable patient information where others can see it risks impermissible disclosure, so a de-identified tracking method is preferable. Verbal consent does not adequately protect other patients' privacy, and posting diagnoses compounds the exposure.

Question 18Medical Office Administration

Which code set is used to report physician services such as office visits and procedures?

  1. NDC
  2. DRG
  3. CPT Correct answer.
  4. ICD-10-PCS

Explanation

CPT codes describe medical services and procedures performed by physicians and other qualified providers. ICD-10-PCS reports inpatient procedures, NDC identifies drugs, and DRGs classify inpatient hospital stays.

Question 19Medical Office Administration

A patient calls asking whether a test is covered. The front desk confirms benefits by phone with the payer. What should staff tell the patient?

  1. Verification is not a guarantee of payment Correct answer.
  2. Coverage is guaranteed because the payer confirmed it
  3. The practice will waive any denial
  4. The patient must pay the full cost regardless

Explanation

Benefit verification reflects information available at the time of the call and does not guarantee payment, since eligibility, medical necessity, and claim review can change the outcome. Promising guaranteed coverage, full patient liability, or automatic waivers misstates the practice's position.

Question 20Medical Office Administration

Which record-keeping practice supports accurate audit trails?

  1. Leaving corrections unmarked
  2. Documenting late entries with the actual date and time Correct answer.
  3. Backdating entries to match the visit date
  4. Deleting erroneous entries without a note

Explanation

Late entries should be clearly identified with the date and time they are made so the record reflects when information was added. Backdating, unmarked corrections, and undocumented deletions compromise the integrity of the record.

Question 21Medical Office Administration

A patient's account has a $500 balance that is 120 days past due with no payment arrangement. What is the appropriate next step in most practices?

  1. Refuse all future appointments
  2. Follow the written financial policy sequence, including statements and contact Correct answer.
  3. Erase the balance as bad debt
  4. Immediately send the account to collections

Explanation

Practices should follow their documented financial policy, which typically includes statements, reminder contacts, and discussion of payment options before escalation. Immediate collections, write-offs, or refusal of care skip required steps and may create compliance issues.

Question 22Medical Office Administration

Which action correctly handles a patient who arrives without their insurance card but is already in the system?

  1. Turn the patient away until the card is presented
  2. Verify coverage in the system and request the card at a later visit Correct answer.
  3. Bill the visit as self-pay permanently
  4. Ask another patient to confirm the coverage

Explanation

If coverage is already on file, staff can verify eligibility and update the record while requesting the card for the file at a convenient time. Denying care, permanently converting to self-pay, or involving other patients is inappropriate.

Question 23Medical Office Administration

Which statement accurately describes an explanation of benefits (EOB)?

  1. It is the patient's signed consent to treat
  2. It is the provider's internal charge master
  3. It is the practice's fee schedule
  4. It is a payer statement showing how a claim was processed Correct answer.

Explanation

An EOB is issued by the insurer and shows billed charges, allowed amounts, payments, and patient responsibility after adjudication. It is not a provider fee schedule, a consent form, or an internal charge document.

Question 24Medical Office Administration

A patient asks staff to discuss their test results with a family member who is present. What should staff do?

  1. Provide the results to anyone who asks
  2. Ask the family member to leave the building
  3. Discuss the results because the family member is present
  4. Confirm the patient's permission before disclosing information Correct answer.

Explanation

Staff should confirm the patient's authorization before sharing protected health information with a family member, even if that person is present. Disclosing without permission or to anyone who asks violates privacy, and ejecting the family member is unnecessary.

Question 25Medical Office Administration

Which metric best indicates how effectively a practice is collecting what it is owed?

  1. Number of appointments per provider
  2. Accounts receivable days outstanding Correct answer.
  3. Average visit length
  4. Number of new patients per month

Explanation

Days in accounts receivable measures how long it takes to collect outstanding balances, making it a key indicator of collection efficiency. Patient volume and visit length reflect operational throughput rather than revenue collection.

Question 26Medical Office Administration

Which document authorizes a patient's insurance plan to pay the provider directly for covered services?

  1. The superbill
  2. The assignment of benefits Correct answer.
  3. The advance beneficiary notice
  4. The remittance advice

Explanation

An assignment of benefits transfers the patient's right to collect insurance payment to the provider, allowing direct reimbursement. It is typically signed during registration along with the financial policy acknowledgment.

Question 27Medical Office Administration

A patient's employer-sponsored plan and a spouse's employer plan both cover the same service. Which rule generally determines the order of benefits when the patient is the subscriber on both plans?

  1. The birthday rule Correct answer.
  2. The plan the patient enrolled in most recently pays first
  3. The plan with the lower deductible pays first
  4. The plan with the larger network pays first

Explanation

When a patient is the subscriber on both plans (for example, two jobs), coordination of benefits generally uses the birthday rule, under which the plan of the subscriber whose birthday falls earlier in the year is primary. Deductible size and network size do not control the order.

Question 28Medical Office Administration

A patient calls to schedule an appointment and mentions they are covered by a plan the practice does not contract with. What is the most appropriate next step?

  1. Schedule the visit and bill the patient's secondary insurance as primary
  2. Schedule the visit and explain that the patient may be responsible for charges as an out-of-network patient Correct answer.
  3. Decline to schedule until the patient changes insurance plans
  4. Schedule the visit and waive any out-of-network cost sharing

Explanation

Practices may see out-of-network patients but must inform them in advance of the potential for higher out-of-pocket costs so the patient can make an informed decision. Refusing care outright or misrepresenting billing order is inappropriate.

Question 29Medical Office Administration

Which schedule is used to define the practice's regular working hours, holidays, and provider availability for appointment booking?

  1. The recall list
  2. The aging report
  3. The fee schedule
  4. The provider template Correct answer.

Explanation

A provider template lays out the blocks of time available for appointments, including administrative time and closures, and is the basis for scheduling. It differs from financial and follow-up tools.

Question 30Medical Office Administration

A patient arrives for a follow-up visit and reports a new medication started by an outside specialist. What is the best action for the front office staff?

  1. Add the medication to the active list without review
  2. Document the reported medication in the chart for the clinical team to review and reconcile Correct answer.
  3. Record the medication in the billing notes instead of the chart
  4. Tell the patient to bring it up only if the provider asks

Explanation

Front office staff should capture patient-reported information and route it to the clinical team, who are responsible for medication reconciliation. Staff should not independently alter the active medication list.

Question 31Medical Office Administration

Which action best supports a clean claim when a payer requires a referral number for specialist visits?

  1. Submit the claim and add the referral only if denied
  2. Have the patient obtain the referral after the visit
  3. Attach a copy of the referral to the patient's statement
  4. Verify the referral is on file and enter the number on the claim before submission Correct answer.

Explanation

When a payer requires a referral, the claim must carry the referral number at first submission to avoid denial. Confirming it before the claim goes out prevents rework and delays.

Question 32Medical Office Administration

A patient asks to pay a large balance over several months. Which practice is most appropriate for the front office to follow?

  1. Establish a written payment plan documenting amounts and due dates and have the patient sign it Correct answer.
  2. Require full payment immediately or cancel future appointments
  3. Postpone all billing until the balance is resolved
  4. Accept verbal promises of payment without documentation

Explanation

Payment plans should be documented in writing with clear terms signed by the patient so both parties understand the obligation and the practice can track compliance. Verbal arrangements are difficult to enforce and audit.

Question 33Medical Office Administration

Which document must a practice provide to a patient explaining how their health information may be used and disclosed?

  1. The assignment of benefits
  2. The consent for treatment
  3. The financial policy
  4. The Notice of Privacy Practices Correct answer.

Explanation

The Notice of Privacy Practices describes permitted uses and disclosures of protected health information and the patient's rights, and its receipt is acknowledged. The other documents address payment or consent to care rather than privacy disclosures.

Question 34Medical Office Administration

A patient's chart contains a note from a prior visit that appears to have been entered on the wrong patient's record. What is the best action?

  1. Copy the note into the correct patient's chart without notifying anyone
  2. Report the discrepancy to the supervising clinician or compliance officer for correction through the proper process Correct answer.
  3. Delete the note from the record entirely
  4. Leave the note as is to preserve the original record

Explanation

Records must remain accurate and auditable, so errors are corrected through an amendment or addendum process rather than deleted or silently copied. Reporting the discrepancy ensures the fix is documented properly.

Question 35Medical Office Administration

Which term describes the process of reviewing a claim for accuracy and completeness before it is sent to the payer?

  1. Posting
  2. Claims scrubbing Correct answer.
  3. Appealing
  4. Claims adjudication

Explanation

Claims scrubbing checks a claim against payer edits for missing or inconsistent data before submission. Adjudication is the payer's decision process, posting records payments, and appeals challenge denials.

Question 36Medical Office Administration

A payer denies a claim as a duplicate. The practice confirms the service was performed only once. What is the most appropriate next step?

  1. Resubmit the identical claim immediately
  2. Review the claim history and submit a corrected claim or appeal with supporting documentation Correct answer.
  3. Bill the patient for the full amount right away
  4. Write off the balance without further action

Explanation

A duplicate denial may reflect a prior paid claim or a data error, so the practice should check claim history and respond with a corrected claim or appeal documenting the service. Immediate resubmission of the same claim may be denied again.

Question 37Medical Office Administration

Which action best protects patient confidentiality at the front desk?

  1. Posting appointment times on a visible whiteboard
  2. Leaving charts on the counter between patients
  3. Discussing billing details in the open waiting area
  4. Turning computer screens away from public view and lowering voices during check-in Correct answer.

Explanation

Positioning screens out of public view and speaking discreetly limit incidental disclosure of protected health information. Physical safeguards at the front desk are part of reasonable privacy protections.

Question 38Medical Office Administration

A patient's insurance card shows a different member ID than the one on file. What is the most appropriate action before the visit is billed?

  1. Update the insurance information in the system and verify eligibility with the payer Correct answer.
  2. Bill using the old member ID to avoid delays
  3. Ask the patient to call the payer themselves and report back
  4. Record the new ID on a sticky note for later

Explanation

Insurance data must be current in the system so claims carry the correct member identifier. Verifying eligibility with the payer at the time of the change prevents denials.

Question 39Medical Office Administration

Which report would a manager review to see how much of the practice's charges were collected and how much was adjusted or written off over a period?

  1. The staff scheduling report
  2. The appointment no-show report
  3. The practice management production and collection report Correct answer.
  4. The patient recall report

Explanation

Production and collection reports summarize charges, payments, and adjustments so managers can evaluate revenue cycle performance. The other reports concern scheduling and follow-up rather than financial performance.

Question 40Medical Office Administration

A new patient cannot recall a prior immunization date, and the practice needs it for the record. What is the best approach?

  1. Request records from the prior provider with a signed authorization and document the request Correct answer.
  2. Guess the date based on the patient's age
  3. Leave the field blank permanently
  4. Enter the date the patient thinks is close without noting the source

Explanation

Obtaining records from another provider requires a valid patient authorization, and the request should be documented in the chart. Fabricating or approximating clinical data undermines record accuracy.

Question 41Medical Terminology and Documentation

Which combining form refers to the heart?

  1. cyst/o
  2. cardi/o Correct answer.
  3. cost/o
  4. crani/o

Explanation

Cardi/o is the combining form for heart, seen in terms such as cardiology and myocardial. The other forms denote rib, skull, and bladder respectively.

Question 42Medical Terminology and Documentation

The suffix -itis indicates which condition?

  1. Pain
  2. Inflammation Correct answer.
  3. Abnormal softening
  4. Surgical removal

Explanation

The suffix -itis means inflammation, as in gastritis or dermatitis. Removal is -ectomy, softening is -malacia, and pain is -algia.

Question 43Medical Terminology and Documentation

A patient record states the patient is afebrile. What does this mean?

  1. Without a pulse
  2. With a high fever
  3. Unable to speak
  4. Without fever Correct answer.

Explanation

The prefix a- means without and febrile refers to fever, so afebrile means the patient has no fever. This is a standard descriptor in vital sign documentation.

Question 44Medical Terminology and Documentation

Which abbreviation commonly documents a patient's blood pressure?

  1. BM
  2. BS
  3. BP Correct answer.
  4. Bx

Explanation

BP is the standard abbreviation for blood pressure and is recorded with systolic and diastolic values. The other abbreviations refer to blood sugar, bowel movement, and biopsy.

Question 45Medical Terminology and Documentation

The term tachycardia describes a heart rate that is:

  1. Absent
  2. Irregular in rhythm
  3. Faster than normal Correct answer.
  4. Slower than normal

Explanation

Tachy- means fast and -cardia refers to heart rate, so tachycardia is a rate above the normal range. Bradycardia describes a slow rate, and asystole describes absence of cardiac activity.

Question 46Medical Terminology and Documentation

In the term subcutaneous, the prefix sub- means:

  1. Through
  2. Above
  3. Beneath Correct answer.
  4. Around

Explanation

The prefix sub- means under or beneath, so subcutaneous means beneath the skin. This is used to describe injection routes and tissue layers.

Question 47Medical Terminology and Documentation

Which term means surgical repair of a joint?

  1. Arthralgia
  2. Arthroscopy
  3. Arthroplasty Correct answer.
  4. Arthrotomy

Explanation

Arthr/o means joint and -plasty means surgical repair, so arthroplasty is joint repair. Arthroscopy is visual examination, arthrotomy is incision, and arthralgia is joint pain.

Question 48Medical Terminology and Documentation

The medical record abbreviation NPO instructs that the patient should:

  1. Receive nothing but oxygen
  2. Take nothing by mouth Correct answer.
  3. Be positioned on the side
  4. Be given a full liquid diet

Explanation

NPO is derived from the Latin nil per os, meaning nothing by mouth. It is used to indicate that oral intake is withheld, often before procedures.

Question 49Medical Terminology and Documentation

A patient is described as having bilateral knee pain. This means the pain is located:

  1. On the left side only
  2. On both sides Correct answer.
  3. Above the knee
  4. Behind the knee

Explanation

The prefix bi- means two, so bilateral indicates involvement of both sides. Laterality terms are essential for accurate documentation.

Question 50Medical Terminology and Documentation

A provider documents hepatomegaly. Which finding does this describe?

  1. Inflamed liver
  2. Painful liver
  3. Enlarged liver Correct answer.
  4. Enlarged spleen

Explanation

Hepat/o means liver and -megaly means enlargement, so hepatomegaly is an enlarged liver. Splenomegaly refers to the spleen and hepatitis to inflammation.