CBCS Final Exam All Possible Questions and Answers
Solved 100%
A patient's health plan is referred to as the payer of last resort. The patient is covered by which of the
following health plans?
Medicaid
CHAMPA
Medicare
TRICARE -ANS-Medicaid
A provider charged $500 to a claim that had an allowable amount of $400. In which of the following
columns should the CBCS apply the non allowed charge?
-Reference column (For notations)
-Description column
-Payment column
-Adjustment column of the credits -ANS-Adjustment column of the credits
Which of the following statements is correct regarding a deductible?
-Coinsurance is a type of deductible
-The physician should write off the deductible
-The insurance company pays for the deductible
-The deductible is the patient's responsibility -ANS-The deductible is the patient's responsibility
Which of the following color formats allows optical scanning of the CMS-1500 claim form?
-Red
-Blue
-Green
-black -ANS-red
Ambulatory surgery centers, home health and hospice organizations use the ______.
-CMS-1500 claim form
,-UB-04 claim form
-Advance Beneficiary notice
-First report of injury form -ANS-UB-04
Claims that are submitted without an NPI number will delay payment to the provider because ______.
-The number is the patient' id number
-The number is needed to identify the provider
-Is is used as a claim number
-It is used as a pre authorization number -ANS-The number is needed to identify the provider
Which of the following terms describes when a plan pays 70% of the allowed amount and the patient
pays 30%?
-Coinsurance
-Deductible
-Premium
-copayment -ANS-coinsurance
Which of the following indicates a claim should be submitted on paper instead of electronically?
-The software claims review process indicates the claim is not complete
-The claim needs authorization
-The claim requires an attachment
-The practice management software is non functional. -ANS-the claim requires an attachment
On a remittance advice form, which of the following is responsible for writing off the difference between
the amount billed and the amount allowed by the agreement?
-Provider
-Insurance company
-Patient
-Third party payer -ANS-provider
,A physician is contracted with an insurance company to accept the amount. The insurance company
allows $80 of a $120 billed amount, and $50 of the deductible has not been met. How much should the
physician write off the patient's account?
-$40
-$15
-$0
-$50 -ANS-$40
The unlisted codes can be found in which of the following locations in the CPT manual?
-Appendix L
-Guidelines prior to each section
-End of each body system
-Table of contents -ANS-Guidelines prior to each section
Which of the following blocks should the billing and coding specialist complete the CMS 1500 claims
form for procedure, services or supplies?
-Block 12
-Block 2
-Block 24D
-Block 24J -ANS-Block 24D
-Block 12 (patient's authorization block
-Block 2 ( patient's name)
-Block 24J ( for the rendering provider)
Which of the following blocks requires the patient's authorization to release medical information to
process a claim?
Block 12
Block 13
Block 27
, Block 31 -ANS-Block 12
- Block 13 patient authorization for benefits required for third party payer
- Block 27 accepting assignment of benefits
- Block 31 (treating physician)
Which of the following steps would be part of a physician's practice compliance program?
-HIPAA compliance audit
-Physician recruitment
-Internal monitoring and auditing
-Notice of privacy practice -ANS-Internal monitoring and auditing
Behavior plays an important part of being a team player in a medical practice. Which of the following is
an appropriate action for the CBCS to take?
-Reprimanding another staff member during a team meeting for displaying a bad attitude toward a
patient
-Looking in the medical record of a friend who receives services at the office
-Communicating with the front desk staff during a team meeting about missing information in patient
files
-Questioning the nurse about the provider documentation in the medical record -ANS-Communicating
with the front desk staff during a team meeting about missing information in patient files
Which of the following acts applies to the administrative simplification guideline?
-HIPAA
-Deficit reduction act of 2005
-The patient protection and affordable care act 2009
-National correct coding initiative of 1995 -ANS-HIPAA
Which of the following is an example of a violation of an adult patient's confidentiality?
-While reviewing a claim, the CBCS reads the diagnosis before realizing that the patient is a neighbor
-A CBCS queries the physician about a diagnosis in a patient's medical record
Solved 100%
A patient's health plan is referred to as the payer of last resort. The patient is covered by which of the
following health plans?
Medicaid
CHAMPA
Medicare
TRICARE -ANS-Medicaid
A provider charged $500 to a claim that had an allowable amount of $400. In which of the following
columns should the CBCS apply the non allowed charge?
-Reference column (For notations)
-Description column
-Payment column
-Adjustment column of the credits -ANS-Adjustment column of the credits
Which of the following statements is correct regarding a deductible?
-Coinsurance is a type of deductible
-The physician should write off the deductible
-The insurance company pays for the deductible
-The deductible is the patient's responsibility -ANS-The deductible is the patient's responsibility
Which of the following color formats allows optical scanning of the CMS-1500 claim form?
-Red
-Blue
-Green
-black -ANS-red
Ambulatory surgery centers, home health and hospice organizations use the ______.
-CMS-1500 claim form
,-UB-04 claim form
-Advance Beneficiary notice
-First report of injury form -ANS-UB-04
Claims that are submitted without an NPI number will delay payment to the provider because ______.
-The number is the patient' id number
-The number is needed to identify the provider
-Is is used as a claim number
-It is used as a pre authorization number -ANS-The number is needed to identify the provider
Which of the following terms describes when a plan pays 70% of the allowed amount and the patient
pays 30%?
-Coinsurance
-Deductible
-Premium
-copayment -ANS-coinsurance
Which of the following indicates a claim should be submitted on paper instead of electronically?
-The software claims review process indicates the claim is not complete
-The claim needs authorization
-The claim requires an attachment
-The practice management software is non functional. -ANS-the claim requires an attachment
On a remittance advice form, which of the following is responsible for writing off the difference between
the amount billed and the amount allowed by the agreement?
-Provider
-Insurance company
-Patient
-Third party payer -ANS-provider
,A physician is contracted with an insurance company to accept the amount. The insurance company
allows $80 of a $120 billed amount, and $50 of the deductible has not been met. How much should the
physician write off the patient's account?
-$40
-$15
-$0
-$50 -ANS-$40
The unlisted codes can be found in which of the following locations in the CPT manual?
-Appendix L
-Guidelines prior to each section
-End of each body system
-Table of contents -ANS-Guidelines prior to each section
Which of the following blocks should the billing and coding specialist complete the CMS 1500 claims
form for procedure, services or supplies?
-Block 12
-Block 2
-Block 24D
-Block 24J -ANS-Block 24D
-Block 12 (patient's authorization block
-Block 2 ( patient's name)
-Block 24J ( for the rendering provider)
Which of the following blocks requires the patient's authorization to release medical information to
process a claim?
Block 12
Block 13
Block 27
, Block 31 -ANS-Block 12
- Block 13 patient authorization for benefits required for third party payer
- Block 27 accepting assignment of benefits
- Block 31 (treating physician)
Which of the following steps would be part of a physician's practice compliance program?
-HIPAA compliance audit
-Physician recruitment
-Internal monitoring and auditing
-Notice of privacy practice -ANS-Internal monitoring and auditing
Behavior plays an important part of being a team player in a medical practice. Which of the following is
an appropriate action for the CBCS to take?
-Reprimanding another staff member during a team meeting for displaying a bad attitude toward a
patient
-Looking in the medical record of a friend who receives services at the office
-Communicating with the front desk staff during a team meeting about missing information in patient
files
-Questioning the nurse about the provider documentation in the medical record -ANS-Communicating
with the front desk staff during a team meeting about missing information in patient files
Which of the following acts applies to the administrative simplification guideline?
-HIPAA
-Deficit reduction act of 2005
-The patient protection and affordable care act 2009
-National correct coding initiative of 1995 -ANS-HIPAA
Which of the following is an example of a violation of an adult patient's confidentiality?
-While reviewing a claim, the CBCS reads the diagnosis before realizing that the patient is a neighbor
-A CBCS queries the physician about a diagnosis in a patient's medical record
