On-the-Job Scripts: Processing a Medical Insurance Claim or Prior Authorization
The CMA exam has no oral or hands-on component — there's no examiner evaluating what you say. These are realistic phrases medical assistants actually use on the job for this task, so you walk into the role sounding like someone who's done it before.
Explaining a prior authorization delay to a patient
"Your plan requires approval before we can schedule this — we've submitted the request and it usually takes a few business days."
Explaining an estimated out-of-pocket cost
"Based on your plan, this procedure will likely have a copay or coinsurance of about [amount] — I can get you the exact figure before you decide."
The general rule
Confirm identity before releasing anything, route clinical judgment calls to the provider rather than answering them yourself, and give patients honest, specific updates rather than vague reassurance. These habits apply across almost every medical-assistant-patient interaction, not just this task.
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