CBCS NHA Practice Test
Where is the Evaluation and Management code for the patient found? - ANSWER:
History and physical section
What does the "assignment of benefits" box on the CMS 1500 mean? - ANSWER: The
provider receives payment directly from the payer
What do physicians use to submit claims? - ANSWER: Clearinghouses
What is a clearinghouse? - ANSWER: An independent organization which performs
software edits for physicians offices and distributes those claims to payers
What must be included in authorization to release info? - ANSWER: The receiving entity
What is an aging report? - ANSWER: An overview of the practice's outstanding claims
HIPAA transactions standards apply to which entity? - ANSWER: Clearinghouses,
providers, and third-party payers who submit transactions electronically
What is a physicians review of systems? - ANSWER: Noting symptoms of various body
systems of a patent
Medicare Part D covers? - ANSWER: Prescriptions
Medicare Part C covers? - ANSWER: Medicare Advantage
Medicare Part B Covers? - ANSWER: Outpatient Billing
Medicare Part A covers? - ANSWER: Inpatient Billing
The software claims review process is used to? - ANSWER: Correct Errors
The authorization number needs to be included on paper and electronic claims in order
to be? - ANSWER: Adjudicated
The billing and coding specialist should submit a paper form if the claim requires an? -
ANSWER: Attachment
HIPAA requires claims to be submitted electronically, even if the management software
is? - ANSWER: Non-functional
, What type of provider is allowed to submit paper claims to Medicare? - ANSWER: A
providers office with less that 10 FT employees
What is a Bad Debt? - ANSWER: An amount that has been determined to be
uncollectible.
What is a Discounted Fee? - ANSWER: A reduction of the normal fee
What is a Financial Hardship? - ANSWER: A reduction of the balance due on a patient's
account due to financial difficulty
What is a Professional Courtesy? - ANSWER: A practice used to build bonds between
physicians
Are verbal requests for records from life insurance companies appropriate? - ANSWER:
NO. Must be in writing and have authorization from the patient, parent, of legal guardian
Is identification required when requesting access to patient records? - ANSWER: Yes
Can patients access psychotherapy notes? - ANSWER: Maybe. Not if they are compiled
for lawsuit
Why does correct claim processing rely on accurately completed encounter forms? -
ANSWER: They streamline patient billing by summarizing the services rendered for a
given date of service
What allows a provider to summarize services rendered by a code? - ANSWER:
Encounter Forms
Encounter Forms must be updated every ___ year(s). - ANSWER: 1 year
Encounter Forms must be signed by the? - ANSWER: Provider
When posting payment accurately, which item should the specialist include? -
ANSWER: The Patient's Responsibility
The Birthday Rule is the parent whose birthdate comes? - ANSWER: First in the
calendar year
Copayment should take place at? - ANSWER: The time of service
What is used by providers to remove errors from claims before submittal to third-party
payers? - ANSWER: A Clearinghouse
Where is the Evaluation and Management code for the patient found? - ANSWER:
History and physical section
What does the "assignment of benefits" box on the CMS 1500 mean? - ANSWER: The
provider receives payment directly from the payer
What do physicians use to submit claims? - ANSWER: Clearinghouses
What is a clearinghouse? - ANSWER: An independent organization which performs
software edits for physicians offices and distributes those claims to payers
What must be included in authorization to release info? - ANSWER: The receiving entity
What is an aging report? - ANSWER: An overview of the practice's outstanding claims
HIPAA transactions standards apply to which entity? - ANSWER: Clearinghouses,
providers, and third-party payers who submit transactions electronically
What is a physicians review of systems? - ANSWER: Noting symptoms of various body
systems of a patent
Medicare Part D covers? - ANSWER: Prescriptions
Medicare Part C covers? - ANSWER: Medicare Advantage
Medicare Part B Covers? - ANSWER: Outpatient Billing
Medicare Part A covers? - ANSWER: Inpatient Billing
The software claims review process is used to? - ANSWER: Correct Errors
The authorization number needs to be included on paper and electronic claims in order
to be? - ANSWER: Adjudicated
The billing and coding specialist should submit a paper form if the claim requires an? -
ANSWER: Attachment
HIPAA requires claims to be submitted electronically, even if the management software
is? - ANSWER: Non-functional
, What type of provider is allowed to submit paper claims to Medicare? - ANSWER: A
providers office with less that 10 FT employees
What is a Bad Debt? - ANSWER: An amount that has been determined to be
uncollectible.
What is a Discounted Fee? - ANSWER: A reduction of the normal fee
What is a Financial Hardship? - ANSWER: A reduction of the balance due on a patient's
account due to financial difficulty
What is a Professional Courtesy? - ANSWER: A practice used to build bonds between
physicians
Are verbal requests for records from life insurance companies appropriate? - ANSWER:
NO. Must be in writing and have authorization from the patient, parent, of legal guardian
Is identification required when requesting access to patient records? - ANSWER: Yes
Can patients access psychotherapy notes? - ANSWER: Maybe. Not if they are compiled
for lawsuit
Why does correct claim processing rely on accurately completed encounter forms? -
ANSWER: They streamline patient billing by summarizing the services rendered for a
given date of service
What allows a provider to summarize services rendered by a code? - ANSWER:
Encounter Forms
Encounter Forms must be updated every ___ year(s). - ANSWER: 1 year
Encounter Forms must be signed by the? - ANSWER: Provider
When posting payment accurately, which item should the specialist include? -
ANSWER: The Patient's Responsibility
The Birthday Rule is the parent whose birthdate comes? - ANSWER: First in the
calendar year
Copayment should take place at? - ANSWER: The time of service
What is used by providers to remove errors from claims before submittal to third-party
payers? - ANSWER: A Clearinghouse
