Crucial Exams

AAMA CMA Practice Question

A patient's claim for a complex surgical procedure was denied by their insurance company. The denial stated that the procedure was 'not medically necessary'. Upon review, you discover that the patient's records clearly document the medical necessity of the procedure. What is the most appropriate next step to address this claim denial?

  • Immediately direct the patient to pay for the procedure out-of-pocket since the insurance denied the claim.

  • Resubmit the same claim with an attached note stating the procedure was medically necessary.

  • Adjust the patient's bill to exclude the surgical procedure and proceed with collecting the remaining balance.

  • File an appeal with detailed supporting documentation and a letter from the physician explaining the medical necessity of the procedure.

AAMA CMA
Administrative
Your Score:
Settings & Objectives
Random Mixed
Questions are selected randomly from all chosen topics, with a preference for those you haven’t seen before. You may see several questions from the same objective or domain in a row.
Rotate by Objective
Questions cycle through each objective or domain in turn, helping you avoid long streaks of questions from the same area. You may see some repeat questions, but the distribution will be more balanced across topics.

Check or uncheck an objective to set which questions you will receive.

Wipe Score
Bash, the Crucial Exams Chat Bot
AI Bot