CERTIFIED BILLING AND CODING SPECIALIST (CBCS)
EXAMINATION QUESTIONS AND CORRECT ANSWER
WITH EXPLANATION GRADED A+ STUDY GUIDE
SOUTHERN NEW HAMPSHIRE UNIVERSITY
1. Medical billing involves:
A. Submitting and processing insurance claims
B. Performing surgery
C. Diagnosing diseases
D. Manufacturing drugs
Answer: A
Rationale: Billing deals with claims and reimbursement.
2. The main purpose of billing is to:
A. Receive payment for healthcare services
B. Treat patients
C. Code diagnoses only
D. Perform laboratory tests
Answer: A
Rationale: Billing ensures payment collection.
3. A medical biller works mainly with:
A. Insurance claims and payments
B. Surgical tools
C. Pharmacy drugs
D. Patient diagnosis only
Answer: A
Rationale: Focus is financial processing.
4. A clean claim is one that is:
,A. Free of errors and complete
B. Rejected
C. Missing codes
D. Incomplete
Answer: A
Rationale: Ready for processing.
5. Claim denial occurs when:
A. Information is incorrect or missing
B. Payment is made
C. Coding is correct
D. Approval is given
Answer: A
Rationale: Errors cause rejection.
6. The primary payer in billing is usually:
A. Insurance company
B. Patient only
C. Hospital staff
D. Government only
Answer: A
Rationale: Insurance pays first.
7. Secondary insurance means:
A. Additional coverage after primary payer
B. Main insurance
C. No insurance
D. Emergency insurance only
Answer: A
Rationale: Additional payer.
8. Copayment is:
, A. Fixed amount paid by patient
B. Full payment
C. Insurance refund
D. Billing error
Answer: A
Rationale: Patient share of cost.
9. Deductible is:
A. Amount paid before insurance covers costs
B. Free service
C. Discount
D. Bonus payment
Answer: A
Rationale: Out-of-pocket threshold.
10. Coinsurance is:
A. Percentage of cost shared
B. Fixed fee
C. Full payment
D. Refund
Answer: A
Rationale: Cost sharing.
11. CPT codes are used for:
A. Procedures
B. Diagnoses
C. Insurance plans
D. Hospital names
Answer: A
Rationale: Procedure coding.
12. ICD-10 codes are used for:
EXAMINATION QUESTIONS AND CORRECT ANSWER
WITH EXPLANATION GRADED A+ STUDY GUIDE
SOUTHERN NEW HAMPSHIRE UNIVERSITY
1. Medical billing involves:
A. Submitting and processing insurance claims
B. Performing surgery
C. Diagnosing diseases
D. Manufacturing drugs
Answer: A
Rationale: Billing deals with claims and reimbursement.
2. The main purpose of billing is to:
A. Receive payment for healthcare services
B. Treat patients
C. Code diagnoses only
D. Perform laboratory tests
Answer: A
Rationale: Billing ensures payment collection.
3. A medical biller works mainly with:
A. Insurance claims and payments
B. Surgical tools
C. Pharmacy drugs
D. Patient diagnosis only
Answer: A
Rationale: Focus is financial processing.
4. A clean claim is one that is:
,A. Free of errors and complete
B. Rejected
C. Missing codes
D. Incomplete
Answer: A
Rationale: Ready for processing.
5. Claim denial occurs when:
A. Information is incorrect or missing
B. Payment is made
C. Coding is correct
D. Approval is given
Answer: A
Rationale: Errors cause rejection.
6. The primary payer in billing is usually:
A. Insurance company
B. Patient only
C. Hospital staff
D. Government only
Answer: A
Rationale: Insurance pays first.
7. Secondary insurance means:
A. Additional coverage after primary payer
B. Main insurance
C. No insurance
D. Emergency insurance only
Answer: A
Rationale: Additional payer.
8. Copayment is:
, A. Fixed amount paid by patient
B. Full payment
C. Insurance refund
D. Billing error
Answer: A
Rationale: Patient share of cost.
9. Deductible is:
A. Amount paid before insurance covers costs
B. Free service
C. Discount
D. Bonus payment
Answer: A
Rationale: Out-of-pocket threshold.
10. Coinsurance is:
A. Percentage of cost shared
B. Fixed fee
C. Full payment
D. Refund
Answer: A
Rationale: Cost sharing.
11. CPT codes are used for:
A. Procedures
B. Diagnoses
C. Insurance plans
D. Hospital names
Answer: A
Rationale: Procedure coding.
12. ICD-10 codes are used for:
