Certified Coding Associate (CCA) Practice Exam 2025 – The All-in-One Guide to Master Your Certification!

The correct answer, Medicare administrative contractors (MACs), refers to entities that have been designated by Medicare to process claims and administer payments for services provided to Medicare beneficiaries. MACs play a crucial role in claims processing, as they are responsible for ensuring that providers are appropriately reimbursed for the services they render under Medicare regulations. They serve as intermediaries between the Medicare program and healthcare providers, allowing for streamlined communication and efficient processing of claims.

MACs are tasked with various responsibilities, including managing enrollment, making coverage decisions, and ensuring compliance with Medicare policies. Their establishment is part of efforts to improve the efficiency and effectiveness of the Medicare claims processing system, making it easier for providers to understand their reimbursement processes.

In contrast, Health maintenance organizations (HMOs) and Medicare Advantage plans represent different models within the healthcare system that work within the broader context of Medicare, but they are not specifically the entities focused solely on claims processing in the same manner as MACs. The Federal Employee Health Benefits Program (FEHBP) is a health insurance program for federal employees and their families, but it operates outside of the Medicare claims processing structure. Thus, MACs are the entities specifically described as the newest claims processing payment contracts under Medicare.