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Certified Clinical Medical Assistant (CCMA) — Requirements & Free Practice

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Certified Clinical Medical Assistant (CCMA)

NHA national certification for clinical medical assistants awarded after eligibility and passing its certification examination.

Licensing authority: National Healthcareer Association · Application information

Initial by examination
Certified Clinical Medical Assistant (CCMA)
Eligibility
High school diploma or equivalent, plus a qualifying training program or supervised work experience under NHA's handbook; some training pathways allow taking the exam before completion of employer training or an externship, but credential release is held until completion. California residents using the CCMA work-experience pathway need two years of medical assistant experience in the immediately preceding five years. These are applicant eligibility conditions; the CCMA examination remains the examination dependency.
Structure Claim Id
nha-ccma-route-structure

Certified Clinical Medical Assistant (CCMA)

Provider
National Healthcareer Association
Format
Proctored multiple-choice examination
Exam questions
Total questions: 180; Scored questions: 150; Unscored questions: 30; The total includes the scored and unscored questions.
Time limit
3 hours
Passing score
Scaled score of 390 or higher
Examination outline
  • Foundational Knowledge and Basic Science (10%)
    • Health Care Systems and Settings
    • Medical Terminology
    • Basic Pharmacology
    • Nutrition
    • Psychology
    • Roles, responsibilities, scope of practice, and titles of medical assistants
    • Roles, responsibilities, scope of practice, titles, and credentials of medical providers and allied health personnel
    • Licensing versus certification; maintenance of certification
    • Types of health care organizations and delivery models (for example, outpatient/inpatient, patient centered medical home, collaborative care, accountable care organization, hospice, home health care, mobile health unit)
    • Technology-based methods for providing health care and health information (for example, telehealth/virtual, patient portals)
    • Health care payment models (for example, fee for service, value-based plans)
    • General versus specialty health care and services
    • Ancillary services and complementary therapies
    • Common abbreviations, acronyms, and symbols
    • The Joint Commission’s (TJC) “Do Not Use” List
    • Medical word building (roots, prefixes, suffixes, plurals)
    • Lay terms and medical terms for common conditions, symptoms, and procedures
    • Positional and directional terminology
    • Drug classifications (for example, diuretics, hypoglycemics, analgesics, over-the-counter), indications, commonly prescribed medications
    • Drug classifications and schedules of controlled substances
    • Differences between side effects and adverse effects; and between indications and contraindications
    • Measurements (for both metric and standard systems) and dosage calculations, mathematical conversions/formulas
    • Forms of medication (for example, tablets, patches, capsules)
    • Look-alike/sound-alike medications
    • Routes of medication administration
    • Pharmacokinetics (absorption, distribution, metabolism, excretion)
    • Rights of medication administration
    • Principles of storage and disposal
    • Sources of drug/medication information and FDA regulations
    • Dietary nutrients, suggested guidelines, and food labels
    • Dietary needs related to diseases and conditions (for example, diabetes, kidney disease, celiac disease)
    • Vitamins and supplements
    • Eating disorders
    • Developmental stages
    • Signs and symptoms of common mental health conditions (for example, anxiety, depression, PTSD, ADHD)
    • Environmental and socioeconomic stressors
    • Psychology of the physically disabled, developmentally delayed, and those who have diseases
    • Defense mechanisms
    • End of life and stages of grief
  • Anatomy and Physiology (5.33%)
    • Body Structures and Organ Systems
    • Pathophysiology and Disease Processes
    • Cell structure (for example, nucleus, cell membrane, cytoplasm, ribosomes, mitochondria, lysosomes)
    • Anatomical structures, locations, and positions
    • Structure and function of major body systems, including organs and their locations
    • Interactions between organ systems, homeostasis
    • Signs, symptoms, and etiology of common diseases, conditions, and injuries
    • Diagnostic measures (for example, labs, imaging, biopsies) and treatment modalities (for example, infusion, chemotherapy, medication, surgery)
    • Incidence, prevalence, risk factors, and comorbidities
    • Epidemics and pandemics
  • Clinical Patient Care (56%)
    • Patient Intake and Vitals — 3A1. Ensure patient safety within the clinical setting. 3A2. Identify patient. 3A3. Complete a comprehensive clinical intake process, including the purpose of the visit. 3A4. Measure and obtain vital signs. 3A5. Convert measurements of vital signs. 3A6. Obtain anthropometric measurements. 3A7. Identify, document, and report abnormal signs and symptoms. k43. Patient identifiers (for example, name, date of birth [DOB], medical record number, last 4 digits of Social Security Number [SSN]) k44. Elements of a patient medical/surgical/family/social history k45. Screenings and wellness assessments (for example, tobacco cessation, alcohol use, HIV screening) k46. Mental health screenings (for example, mini mental state exam; anxiety and depression screening tools) k47. Blood pressure—methods for obtaining (manual, palpating, electronic), in-range and out-of-range values, common errors, and trouble-shooting methods k48. Orthostatics—methods for obtaining, common errors k49. Pulse—methods for obtaining in various locations, abnormal rhythms, in-range and out-of-range values k50. Respiratory rate—methods for obtaining, in-range and out-of-range values, types of abnormal patterns (for example, apnea, hyperventilation, dyspnea) k51. Pulse oximetry—in-range and out-of-range values, locations, and common errors k52. Temperature—methods for obtaining in various locations, coordinating ranges, common errors k53. Pain scale k54. Menstrual status and last menstrual period k55. Factors impacting vital signs (for example, age, medications) k56. Conversion formulas for vital signs (for example, height, weight, temperature) k57. Methods for measuring height, weight, BMI, and body and waist circumference; special considerations related to age, health, status, disability k58. Pediatric measurements and growth chart
    • General Patient Care — 3B1. Prepare examination/procedure room. 3B2. Prepare and maintain a sterile field. 3B3. Prepare patient for procedures, including providing education. 3B4. Assist provider with general and specialty physical examination. 3B5. Prepare and administer medications and/or injectables using nonparenteral routes. 3B6. Prepare and administer medications and/or injectables using parenteral routes (excluding intravenous). 3B7. Manage injection logs (for example, controlled substances, tuberculosis medications, immunizations). 3B8. Perform staple and suture removal. 3B9. Perform ear and eye irrigation. 3B10. Administer first aid and basic wound care. 3B11. Identify and respond to emergency/priority situations. 3B12. Assist provider with patients presenting with minor and traumatic injury. 3B13. Assist with surgical interventions (for example, sebaceous cyst removal, toenail removal, colposcopy, cryosurgery). 3B14. Review provider's discharge instructions/plan of care with patients. 3B15. Follow guidelines for sending orders for prescriptions and refills electronically, by telephone, fax, or email. 3B16. Order and obtain durable medical equipment (DME) and supplies (for example, CPAP, wheelchair, hospital bed). 3B17. Document relevant aspects of patient care in patient record. 3B18. Operate basic functions of an electronic medical record/electronic health record (EMR/EHR) system. 3B19. Implement updates in EMR/EHR (for example, quality measures, alerts, telemedicine, population health reporting). 3B20. Enter orders using computerized physician order entry. 3B21. Conduct telehealth or virtual screenings in the context of a telehealth/virtual visit. k59. Guidelines for establishing a sterile field k60. Sterile techniques related to examinations, procedures, injections, and medication administration k61. Positioning and draping requirements for general and specialty examinations, procedures, and treatments k62. Equipment, supplies, and instruments required for general physical examinations k63. Equipment, supplies, and instruments required for specialty examinations or procedures k64. Patient instruction specific to procedures, including pre- and postprocedural instructions k65. Modifications to patient care depending on patient needs (for example, assisting with ambulation and transfers for frail and disabled patients; using terms a child can understand for pediatric patients) k66. Immunization schedules, requirements, and registries; adverse effects documentation and reporting k67. Allergies (for example, medication, food, environmental); contraindications; type of reactions (mild, moderate, and severe); how to respond to allergic reactions or anaphylactic shock k68. Dosage calculations related to injectables and oral medications k69. Commonly used oral and parenteral medications, including forms, packaging, routes of administration, and rights of medication administration k70. Methods of administration, techniques, procedures, and supplies related to eye and ear medications k71. Storage, labeling, expiration dates, and medication logs k72. Techniques (for example, needle angle, gauge, length) and injection site (for example, intramuscular, subcutaneous) k73. Supplies and equipment related to injections k74. Storage of injectables k75. Techniques and instruments for suture and staple removal; types and sizes of sutures k76. Instruments, supplies, and techniques related to eye and ear irrigation k77. Commonly occurring types of injuries (for example, lacerations, abrasions, fractures, sprains, burns) k78. Treatment for commonly occurring types of injuries (for example, bandaging, ice, elevation) k79. Signs and symptoms of wound infection (for example, redness, pus, swelling, discharge) and wound stages k80. Commonly occurring types of surgical interventions k81. Signs and symptoms related to urgent and emergency situations (for example, diabetic shock, heat stroke, allergic reactions, choking, syncope, seizure) k82. Emergency action plans (for example, crash cart, emergency injectables) k83. Procedures to perform CPR, basic life support, and automated external defibrillator (AED) k84. Legal requirements for content and transmission of prescriptions k85. Electronic prescribing software, screening requirements for prescription refills k86. Specialty pharmacies (for example, compounding and nuclear pharmacies; forms of medication available such as liquid, elixir, balm, ointment) k87. Required components of medical records k88. Prior authorizations for medication durable medical equipment (DME) k89. Computerized Physician Order Entry (CPOE) k90. Patient conditions appropriate for telehealth/virtual visit k91. Modifications in care related to delivery of telehealth/virtual health care
    • Infection Control and Safety — 3C1. Adhere to standard and universal precautions and guidelines related to infection control. 3C2. Adhere to regulations and guidelines related to infectious diseases. 3C3. Follow guidelines related to use of personal protective equipment (PPE), including donning and doffing. 3C4. Adhere to guidelines regarding hand hygiene. 3C5. Perform disinfection/sanitization. 3C6. Perform sterilization of medical equipment. 3C7. Perform appropriate aseptic techniques for various clinical situations. 3C8. Dispose of biohazardous materials as dictated by Occupational Safety and Health Administration (OSHA) (for example, sharps containers, biohazard bags). 3C9. Follow post-exposure guidelines (for example, needle safety guidelines, use of eyewash stations). k92. Common pathogens and nonpathogens k93. Organisms and micro-organisms k94. Infectious agents, chain of infection, modes of transmission, and conditions for growth k95. Signs and symptoms of infectious diseases k96. CDC guidelines for infectious disease (for example, prevention, reporting) k97. Guidelines for exposure to bloodborne pathogens (for example, OSHA, American Hospital Association [AHA]) k98. Approaches for the control of infectious diseases, epidemics, and pandemics k99. Universal precautions k100. Standard precautions (for example, personal protective equipment) k101. Handwashing techniques k102. Alcohol-based rubs/sanitizer k103. Sterilization techniques (autoclave, instrument cleaner, germicidal disinfectants, disposables) and principles for maintaining sterilization equipment k104. Techniques for medical and surgical asepsis k105. Order of cleaning and types of cleaning products k106. Safety Data Sheets (SDS) k107. Cautions related to chemicals k108. Disposal methods k109. Exposure control plan k110. Logs (for example, maintenance, equipment servicing, temperature, quality control)
    • Point of Care Testing and Laboratory Procedures — 3D1. Collect nonblood specimens (for example, urine, stool, cultures, sputum). 3D2. Perform CLIA-waived testing. 3D3. Recognize, document, and report in-range and out-of-range laboratory and test values. 3D4. Match and label specimen to patient and completed requisition. 3D5. Process, handle, and transport collected specimens. 3D6. Perform vision and hearing tests. 3D7. Perform allergy testing. 3D8. Perform spirometry/pulmonary function tests (electronic or manual). 3D9. Identify common testing errors leading to testing discrepancies or inaccurate results. k111. Point-of-care testing k112. Information required on completed requisition and/or form per provider order (for example, type of test, date, time, diagnostic code) k113. Specimen collection techniques and requirements k114. CLIA-waived testing regulations k115. Quality controls (internal and external) k116. In-range and out-of-range laboratory and test values k117. Preanalytical and postanalytical errors that affect testing results k118. Elements related to vision and hearing tests k119. Peak flow rates k120. Scratch test and intradermal allergy test k121. Requirements for transportation, diagnosis, storage, and disposal of specimens (for example, patient identifiers, site, test, chain of custody)
    • Phlebotomy — 3E1. Prepare patient for procedure. 3E2. Verify order details. 3E3. Select appropriate supplies for test(s) ordered (for example needle sizes, tubes). 3E4. Determine venipuncture site accessibility based on patient age and condition. 3E5. Prepare site for venipuncture. 3E6. Determine order of draw. 3E7. Perform venipuncture. 3E8. Perform capillary puncture. 3E9. Perform postprocedural care. 3E10. Handle blood samples as required for diagnostic purposes. 3E11. Process blood specimens for laboratory. 3E12. Match and label specimen to patient and completed requisition. 3E13. Recognize and respond appropriately to out-of-range test results. 3E14. Prepare samples for transportation to a reference (outside) laboratory. 3E15. Follow guidelines in distributing laboratory results to providers after matching patient to provider. k122. Blood components (for example, whole blood, plasma, serum platelets) k123. Bloodborne pathogens k124. Patient identifiers, content of requisition (for example, site or test, diagnostic code, dietary restrictions) k125. Patient preparation (for example, fasting/nonfasting, medication use, basal state, positioning) k126. Assessment of patient comfort/anxiety level with procedure k127. Considerations related to special patient needs (for example, need for support person or witness, use of restraints, chain of custody) k128. Medical conditions or history and medications affecting collection of blood k129. Blood vacuum tubes required for chemistry, hematology, and microbiology testing k130. Phlebotomy site preparation, including cleansing, wrapping, order of draw with microtubes k131. Anatomy, skin integrity, venous sufficiency, contraindications k132. Order of draw for venipuncture k133. Insertion and removal techniques k134. Evacuated tube, syringe, and butterfly methods k135. Types of tubes, tube positions, number of tube inversions, and fill level/ratios k136. Additives and preservatives k137. Bandaging procedures, including allergies and skin types k138. Preanalytical and postanalytical considerations pertaining to specimen quality and consistency k139. Special collections (for example, timed specimens, medication levels, blood cultures, fasting) k140. Centrifuge and aliquot k141. Expected and unexpected test values; control values k142. Equipment calibration k143. Storage conditions related to sensitivity to light and temperature k144. Requirements for transportation, diagnosis, storage, disposal k145. Processing and labeling requirements k146. External databases (for example, outside laboratories, reference sources)
    • EKG and Cardiovascular Testing — 3F1. Prepare patient for EKG or ambulatory cardiac monitoring procedure. 3F2. Identify types of leads and proper anatomical electrode placement. 3F3. Perform EKG tests. 3F4. Recognize abnormal or emergent EKG results (for example, dysrhythmia, arrhythmia, versus artifact). 3F5. Assist provider with ambulatory cardiac monitoring (for example, stress test, Holter monitoring, event monitoring). 3F6. Transmit results or report to patient's electronic medical record or paper chart and provider. 3F7. Ensure proper functioning and storage of EKG equipment. k147. Techniques and methods for EKGs k148. Procedures and instructions to minimize artifacts k149. Artifacts, signal distortions, and electrical interference (for example, fuzz, wandering baseline) k150. Preparation, positioning, and draping of patient k151. Considerations related to patient characteristics (for example, anatomy, adult/pediatric, medical condition) k152. Supplies needed (for example, paper, correct leads, razor, tape) k153. Placement of limb and chest electrodes k154. Signs of adverse reaction during testing (for example, signs of distress, elevated blood pressure, respiration) k155. Abnormal rhythms or dysrhythmias associated with EKGs k156. Waveforms, intervals, segment k157. Calibration of equipment
  • Patient Care Coordination and Education (8%)
    • Review patient records prior to visit to ensure health care is comprehensively addressed.
    • Ensure that documentation of preventative maintenance and screenings is included in patient record.
    • Identify timelines and track recommendations for screenings and preventative maintenance (for example, mammogram, Papanicolaou (Pap) test, colonoscopy, immunizations).
    • Assist provider with researching and supplying information on community resources for clinical and non-clinical services.
    • Coordinate with health care providers and community-based organizations for continuity of care.
    • Facilitate patient compliance (for example, continuity of care, follow up, medication compliance) to optimize health outcomes.
    • Participate in team-based patient care (for example, patient-centered medical home [PCMH], accountable care organization [ACO]).
    • Participate in transition of care for patients.
    • Provide patient education via telehealth/virtual visit systems and processes.
    • Provide education to patients on communicable disease prevention.
    • Preventive medicine, preventive screenings, and wellness
    • Clinical quality measures
    • Education delivery methods, instructional techniques, and learning styles for in-person and virtual visits
    • Patient education related to nutrition and healthy eating, including restrictions, recommendations, and relation to medications
    • Available resources for clinical services (for example, home health care)
    • Resources and procedures to coordinate care and outpatient services
    • Available community resources for non-clinical services (for example, adult day care, transportation vouchers)
    • Specialty resources for patient/family medical and cognitive needs
    • Barriers to care (for example, socioeconomic, cultural differences, language, education)
    • Roles and responsibilities of team members involved in patient-centered medical home (PCMH) and team-based care (TBC)
    • Referral forms and processes
    • Methods for the prevention of transmission communicable diseases
  • Administrative Assisting (8%)
    • Schedule and monitor patient appointments using electronic and paper-based systems.
    • Determine the type of appointment needed.
    • Prioritize appointment needs based on urgency.
    • Monitor patient flow sheets, superbill, or encounter forms.
    • Verify insurance coverage/financial eligibility.
    • Identify and check patients in/out.
    • Confirm appropriate diagnostic and procedural codes.
    • Obtain and verify prior authorizations and precertifications (for example, for prescriptions, procedures, radiology).
    • Prepare documentation and billing requests using current coding guidelines.
    • Ensure that documentation complies with government and insurance requirements.
    • Perform charge reconciliation (for example, enter charges, post payments, make adjustments, process accounts receivable).
    • Bill patients, insurers, and third-party payers for services performed.
    • Resolve billing issues with insurers and third-party payers, including appeals and denials.
    • Manage electronic and paper-based medical records.
    • Process office mail and faxes to appropriate staff member.
    • Facilitate/generate referrals to other health care providers and allied health care professionals.
    • Follow up patient calls and appointment confirmations.
    • Enter information into databases or spreadsheets (for example, electronic medical record [EMR], electronic health record [EHR], Excel, billing modules, scheduling systems).
    • Participate in safety evaluations and report safety concerns.
    • Maintain inventory of clinical and administrative supplies.
    • Activate and facilitate use of patient portals.
    • Provide technical instruction on the use of telehealth/virtual visits and troubleshoot issues.
    • Types of office visits (for example, new patient, telehealth/virtual, annual wellness, specialty, sports/school physical), and requirements for each
    • Screening methods to identify type of appointment needed
    • Practice management systems and software (for example, EMR/EHR, scheduling software, paper-based filing systems, office storage for archived files)
    • Requirements related to duration of visits (for example, purpose of visit, physician preferences)
    • Sections of the medical record (for example, administrative, clinical, billing, procedural, notes, consents)
    • Required documentation for patient review and signature
    • Chart review
    • Electronic referrals (for example, creation, requirements, administration)
    • Financial eligibility, sliding scales, and indigent programs
    • Government regulations (for example, promoting interoperability/meaningful use, Medicare Access and CHIP Reauthorization Act of 2015 [MACRA])
    • CMS billing and documentation requirements
    • Insurance fundamentals, including revenue cycle and incentive models
    • Insurance terminology (for example, copayment, coinsurance, deductible, tier levels, explanation of benefits, medical necessity)
    • Referral and insurance authorizations, pre-certification requirements (for example, surgical, diagnostics, labs)
    • Diagnostic and procedural codes
    • Third-party payer billing requirements
    • Advanced beneficiary notice (ABN)
    • Aging reports, collections due, adjustments, and write-offs
    • Online banking for deposits and electronic transfers
    • Auditing methods, processes, and sign-offs
    • Data entry and data fields
    • Equipment inspection logs, required schedules, and compliance requirements, including inspection by medical equipment servicers
    • Telehealth/virtual visit technologies, barriers to access
  • Communication and Customer Service (8%)
    • Recognize the diversity of patient cultures and backgrounds when providing care.
    • Recognize stereotypes and biases and interact appropriately with patients, colleagues, and others.
    • Modify verbal and nonverbal communication for diverse audiences (for example, providers, coworkers, supervisors, patients and caregivers, external providers).
    • Modify verbal and nonverbal communications with patients and caregivers based on special considerations (for example, pediatric, geriatric, hearing, vision, or cognitive impairment).
    • Modify communications based on type of visit (for example, in-person, telehealth/virtual visits).
    • Clarify and relay communications between patients and providers.
    • Communicate on the telephone with patients and caregivers, providers, third-party payers using HIPAA guidelines.
    • Prepare written/electronic communications/business correspondence.
    • Handle challenging/difficult customer service occurrences.
    • Utilize conflict management and complaint resolution to improve patient satisfaction.
    • Engage in crucial conversations with patients and caregivers/health care surrogates, staff, and providers.
    • Facilitate teamwork and team engagement.
    • Demonstrate professionalism (for example, appropriate demeanor, clothing, language, tone).
    • Cultural, religious, psychosocial, and economic considerations impacting provision of care
    • Gender identity and expression, pronoun use
    • Patient characteristics affecting communication (for example, language barriers, age, developmental stage, cognitive, sensory, and physical impairments)
    • Communication styles appropriate to oral, telephone, email, text communications
    • Nonverbal cues for in-person and telehealth/virtual communication
    • Communication cycle (clear, concise message relay)
    • Therapeutic communication
    • Interviewing and questioning techniques, including screening questions, open-ended, closed-ended, and probing questions
    • Scope of permitted questions and boundaries for questions
    • Active listening techniques
    • Coaching and feedback, positive reinforcement of effective behavior
    • Telephone etiquette
    • Email etiquette
    • Business letter formats
    • Patient satisfaction surveys
    • Techniques to deal with patients (for example, irate clients, custody issues between parents, chain of command)
    • Conflict management and dispute resolution methods
    • When to escalate problem situations
    • Incident/event/unusual occurrence reports; documentation of event
    • Cause and effect analysis (for example, risk management related to patient and employee safety)
    • Professional presence (for example, appearance, demeanor, tone)
  • Medical Law and Ethics (4.67%)
    • Comply with legal and regulatory requirements.
    • Obtain patient consent as needed.
    • Adhere to professional codes of ethics.
    • Obtain, review, and comply with medical directives (for example, advance directives, living will, health care proxy, medical order for life sustaining treatment).
    • Protect patient privacy and confidentiality, including medical records.
    • Adhere to legal requirements regarding reportable violations or incidents.
    • Identify personal or religious beliefs and values and provide unbiased care.
    • Laws and regulations (for example, HIPAA, ACA, HERCA, Health Information Technology for Economic and Clinical Health [HITECH], 21st Century CARES Act, Controlled Substances Act)
    • Patient’s Bill of Rights
    • Informed (verbal or written) and implied consent, including consideration for minors and those unable to give consent
    • Advanced directives (for example, living will, do-not-resuscitate/do-not-intubate [DNR/DNI], Medical Orders for Life-Sustaining Treatment [MOLST] form)
    • Power of attorney and legal guardianship
    • Legal requirements related to maintenance, storage, and disposal of records
    • Conditions for sharing information/release of information
    • Criminal and civil acts; medical malpractice
    • Mandatory reporting laws, sign and symptoms of abuse, triggers for reporting, and reporting agencies
Examination sources