CPB Final Exam || Most Recent Exam 2026-2027 Actual
Complete Real Exam Questions And Correct Answers
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A claim has been denied as not medically necessary. The
biller has checked
the medical record and the medical policy and verified it
is not covered
according to the carrier's medical policy. What is the next action
the biller should
take? - ANSWER-Check with the provider to appeal the claim
and if necessary
write off the
balance.
A provider removes a skin lesion in an ASC and receives a
denial from the insurance company that states "lower level of
care". What steps should the biller take? - ANSWER-Check with
the provider and write an appeal explaining why the service
required the ASC.
A claim was resubmitted to Medicare through a clearinghouse
60 days after the date of service and the claim was denied. The
biller checked the clearinghouse claim status system and
determined Medicare did not receive the claim. What action
should the biller take? - ANSWER-Check the clearinghouse
,reports and appeal the denial with proof of the claims
submission.
What does a high number of days in A/R indicate for a
medical practice? -
ANSWER-The practice potentially has a problem in the
revenue cycle.
What should be included in a financial policy?
A. Convey that the patient balances are due at the time of
service
B. List insurances the providers are contracted with
C. List insurances the providers are not contracted with
D. List the practice's policy for out-of-network insurance
policies
E. List the patients on the Medicaid roster - ANSWER-A, B, D
Which statement is true about a patients insurance? -
ANSWER-Verification
should happen at each
visit.
Which option below is the better way to ask the patient
about their current
demographic information? - ANSWER-What is your
current address?
Review the following office policy: Financial policy:
, You are responsible for paying all co-pays at the time of
service. Co-pays, coinsurance, deductibles and non-covered
services can not be waived by our office, as it is a
requirement placed on you by your insurance carrier... Co-
pay collection fee: If we must bill you for your co-pay, you
may be required to pay a $20 co-pay collection fee.
When must a co-pay be collected from the office by the patient
to avoid a penalty? - ANSWER-At the time of service.
When a provider wants to give a discount on services to a
patient, which option
is acceptable? - ANSWER-The provider must discount the
change prior to
billing the insurance
carrier.
What is a prompt pay discount? - ANSWER-A discount
given to self-pay
patients when they pay for the service at the time
of the visit.
Which act protects information collected by the consumer
reporting agencies? -
ANSWER-Fair Credit
Reporting Act
What steps should be taken when a medical office receives
notice that a patient
Complete Real Exam Questions And Correct Answers
(Verified Answers) Already Graded A+ | Guaranteed
Success!! Newest Exam | Just Released!!
A claim has been denied as not medically necessary. The
biller has checked
the medical record and the medical policy and verified it
is not covered
according to the carrier's medical policy. What is the next action
the biller should
take? - ANSWER-Check with the provider to appeal the claim
and if necessary
write off the
balance.
A provider removes a skin lesion in an ASC and receives a
denial from the insurance company that states "lower level of
care". What steps should the biller take? - ANSWER-Check with
the provider and write an appeal explaining why the service
required the ASC.
A claim was resubmitted to Medicare through a clearinghouse
60 days after the date of service and the claim was denied. The
biller checked the clearinghouse claim status system and
determined Medicare did not receive the claim. What action
should the biller take? - ANSWER-Check the clearinghouse
,reports and appeal the denial with proof of the claims
submission.
What does a high number of days in A/R indicate for a
medical practice? -
ANSWER-The practice potentially has a problem in the
revenue cycle.
What should be included in a financial policy?
A. Convey that the patient balances are due at the time of
service
B. List insurances the providers are contracted with
C. List insurances the providers are not contracted with
D. List the practice's policy for out-of-network insurance
policies
E. List the patients on the Medicaid roster - ANSWER-A, B, D
Which statement is true about a patients insurance? -
ANSWER-Verification
should happen at each
visit.
Which option below is the better way to ask the patient
about their current
demographic information? - ANSWER-What is your
current address?
Review the following office policy: Financial policy:
, You are responsible for paying all co-pays at the time of
service. Co-pays, coinsurance, deductibles and non-covered
services can not be waived by our office, as it is a
requirement placed on you by your insurance carrier... Co-
pay collection fee: If we must bill you for your co-pay, you
may be required to pay a $20 co-pay collection fee.
When must a co-pay be collected from the office by the patient
to avoid a penalty? - ANSWER-At the time of service.
When a provider wants to give a discount on services to a
patient, which option
is acceptable? - ANSWER-The provider must discount the
change prior to
billing the insurance
carrier.
What is a prompt pay discount? - ANSWER-A discount
given to self-pay
patients when they pay for the service at the time
of the visit.
Which act protects information collected by the consumer
reporting agencies? -
ANSWER-Fair Credit
Reporting Act
What steps should be taken when a medical office receives
notice that a patient
