Certified Clinical Medical Assistant CCMA Practice Test

An MA is determining the amount a patient will be required to pay for a scheduled procedure that has an allowable amount of $200. The patient has a $20 copayment, a 90/10 coinsurance, and has met his deductible. What is the total amount the patient will pay the provider for this procedure?

1. $120

2. $50

3. $40

4. $30

The correct answer is: $40

To find the total amount the patient will need to pay for the scheduled procedure, we first need to look at the specific components of the payment structure. The allowable amount for the procedure is set at $200. The patient has a copayment of $20, which is a fixed amount they pay at the time of service. This initial payment is straightforward; it is a standard part of many health insurance plans. After the copayment, we consider the insurance coverage. The patient has a coinsurance of 90/10, meaning that the insurance covers 90% of the allowed amount after the copayment has been applied. Since the patient has met their deductible, they will not owe any additional amount for that. Calculating the coinsurance involves determining 10% of the remaining amount after the copayment: 1. Subtract the copayment from the allowable amount: $200 - $20 = $180. 2. Now, calculate the coinsurance amount the patient is responsible for: 10% of $180 = $18. 3. Finally, add the copayment to this coinsurance amount to get the total the patient will have to pay: $20 (copayment) + $18 (coinsurance) =