NHA BILLING AND CODING TEST BANK
CBCS VERIFIED ACTUAL EXAM PAPER
2026 QUESTIONS WITH ANSWERS GRADED
A+
⩥ third party payers. Answer: include insurance companies, Medicare
and Medicaid
⩥ informed consent. Answer: pcp explains medical or diagnostic
procedures, surgical intervetions and the benifits and risks involved,
giving an oportunity for pts to ask questions before intervention is
provided
⩥ implied consent. Answer: pt presents for treatment, such as extending
an arm to allow a blood draw
goes voluntarily
⩥ Protected Health Information (PHI). Answer: Any information about
health status, provision of health care, or payment for health care that
can be linked to an individual. This is interpreted rather broadly and
includes any part of a patient's medical record or payment history.
,⩥ clearinghouse. Answer: agency that converts clains into a standardized
electronic format, looks for errors and formats them according to HIPAA
and insurance standards
⩥ individiually identifiable. Answer: documents that identify the person
or provide enought info so that the person coud be identified
⩥ consetn. Answer: pts permission evidenced by signature
⩥ authorization. Answer: permission granted by the pt or the pts
representative to release information for reasons other than treatment,
pyment, or health care operations
⩥ reimbursement. Answer: payment for services rendered by third party
payer
⩥ auditing. Answer: review of claims for accuract and completeness
⩥ fraud. Answer: making falso statements of representations of material
facts to obtain some benifit or payment for which no entitlement would
otherwise exist
⩥ upcoding. Answer: assigning diagnosis/procedure code at a higher
level than the documentation supports
, ⩥ unbundling. Answer: using multiplr codes that describe different
components of a treatment instead of using a single code that describes
all the steps
⩥ abuse. Answer: practices that directly or indirectly result in
unnecessary costs to the medicare program
⩥ final rule. Answer: business associates must ensure that PHI remains
sucure, and they are expected to report any breaches in security
⩥ stark law. Answer: pcps are not allowed to refer pts to a pcp with
whom they have a financial relationship with
⩥ CMS. Answer: has oversight responsibilities to stark law
⩥ false claims act. Answer: protects the government from being
overcharges for services provider or sold, or substandard goos or
services
⩥ Office of the Inspector General (OIG). Answer: has the authority to
exclude individuals and entities who have engages in fraud and abuse
from participating in Medicare, Medicaid, and other federal helath care
programs
CBCS VERIFIED ACTUAL EXAM PAPER
2026 QUESTIONS WITH ANSWERS GRADED
A+
⩥ third party payers. Answer: include insurance companies, Medicare
and Medicaid
⩥ informed consent. Answer: pcp explains medical or diagnostic
procedures, surgical intervetions and the benifits and risks involved,
giving an oportunity for pts to ask questions before intervention is
provided
⩥ implied consent. Answer: pt presents for treatment, such as extending
an arm to allow a blood draw
goes voluntarily
⩥ Protected Health Information (PHI). Answer: Any information about
health status, provision of health care, or payment for health care that
can be linked to an individual. This is interpreted rather broadly and
includes any part of a patient's medical record or payment history.
,⩥ clearinghouse. Answer: agency that converts clains into a standardized
electronic format, looks for errors and formats them according to HIPAA
and insurance standards
⩥ individiually identifiable. Answer: documents that identify the person
or provide enought info so that the person coud be identified
⩥ consetn. Answer: pts permission evidenced by signature
⩥ authorization. Answer: permission granted by the pt or the pts
representative to release information for reasons other than treatment,
pyment, or health care operations
⩥ reimbursement. Answer: payment for services rendered by third party
payer
⩥ auditing. Answer: review of claims for accuract and completeness
⩥ fraud. Answer: making falso statements of representations of material
facts to obtain some benifit or payment for which no entitlement would
otherwise exist
⩥ upcoding. Answer: assigning diagnosis/procedure code at a higher
level than the documentation supports
, ⩥ unbundling. Answer: using multiplr codes that describe different
components of a treatment instead of using a single code that describes
all the steps
⩥ abuse. Answer: practices that directly or indirectly result in
unnecessary costs to the medicare program
⩥ final rule. Answer: business associates must ensure that PHI remains
sucure, and they are expected to report any breaches in security
⩥ stark law. Answer: pcps are not allowed to refer pts to a pcp with
whom they have a financial relationship with
⩥ CMS. Answer: has oversight responsibilities to stark law
⩥ false claims act. Answer: protects the government from being
overcharges for services provider or sold, or substandard goos or
services
⩥ Office of the Inspector General (OIG). Answer: has the authority to
exclude individuals and entities who have engages in fraud and abuse
from participating in Medicare, Medicaid, and other federal helath care
programs
