Crucial Exams

AAMA CMA Practice Question

A Medicare-eligible patient arrives at the clinic for a cardiac diagnostic procedure which is administered frequently. Upon review, the provider is concerned that Medicare may not consider the regularity of this particular test to be medically necessary. How should the medical assistant proceed to ensure adherence to Medicare regulations and effective patient communication?

  • Defer the decision to the billing department after the procedure has been completed.

  • Present an Advance Beneficiary Notice (ABN) to the patient, delineating the reasons why the procedure may not be covered and their potential financial responsibility.

  • Conduct the procedure without discussing potential coverage issues, relying on standard Medicare policies.

  • Inform the patient verbally that the clinic will take care of any coverage issues with Medicare.

AAMA CMA
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