CPB EXAM
what is not specified in the 5010 transaction standards - Answer acknowledgement for
patient payments
NUCC stands for - Answer National unified claim committe
ASCA Administrative simplification compliance act - Answer requires claims to be sent
electronically
item 14 qualifier on a CMS form - Answer indicates if the date is a symptom or
menstrual cycle
Aentas guildlines for filing a level 1 or 2 appeal - Answer within 60 calendar days of
previous decision
Liability Issue - Answer commercial insurance was billed before work comp ect
HRA Health Reimubrsement Arrangements - Answer an account that reimburses
employees for specific healthcare expenses funded by employers
Health Savings Account HSA - Answer reimburses employees for specific healthcare
expenses
Flexible Spending Account FSA - Answer reimburses employees for specified expenses
Idemnity, Fee for Service, Traditional Service - Answer traditional plan that reimburses
members based on providers bills submitted after services are rendered
Status Codes - Answer Indicate a service is payable, non payable or bundled into
another service
Who Coordinattes healthcare in TRICARE PRIME - Answer PCM Primary Care
Manager
RBRVS FORMULA - Answer Base code subtracted from the second procedure and is
added to the highest paid code which is paid at 100%
Non Par medicare provider charge formula when a procedures approved medicare fee
is $1,100.00 - Answer 95% of 1,100.00 (1,100 x .95)=1045
$1,045.00 x 115% (1045 x 1.15) = $1,201.75
Tricare options not available to active duty service members? - Answer Tricare extra
and Tricare Standard
what is not specified in the 5010 transaction standards - Answer acknowledgement for
patient payments
NUCC stands for - Answer National unified claim committe
ASCA Administrative simplification compliance act - Answer requires claims to be sent
electronically
item 14 qualifier on a CMS form - Answer indicates if the date is a symptom or
menstrual cycle
Aentas guildlines for filing a level 1 or 2 appeal - Answer within 60 calendar days of
previous decision
Liability Issue - Answer commercial insurance was billed before work comp ect
HRA Health Reimubrsement Arrangements - Answer an account that reimburses
employees for specific healthcare expenses funded by employers
Health Savings Account HSA - Answer reimburses employees for specific healthcare
expenses
Flexible Spending Account FSA - Answer reimburses employees for specified expenses
Idemnity, Fee for Service, Traditional Service - Answer traditional plan that reimburses
members based on providers bills submitted after services are rendered
Status Codes - Answer Indicate a service is payable, non payable or bundled into
another service
Who Coordinattes healthcare in TRICARE PRIME - Answer PCM Primary Care
Manager
RBRVS FORMULA - Answer Base code subtracted from the second procedure and is
added to the highest paid code which is paid at 100%
Non Par medicare provider charge formula when a procedures approved medicare fee
is $1,100.00 - Answer 95% of 1,100.00 (1,100 x .95)=1045
$1,045.00 x 115% (1045 x 1.15) = $1,201.75
Tricare options not available to active duty service members? - Answer Tricare extra
and Tricare Standard
