AAPC CPB Test Bank Questions with Complete Sol
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utions BEST TEST BANK SOLUTION WITH ALLANS
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WERS 100%CORRECT 2022 Graded A+
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,AAPC CPB Test Bank Questions with Complete Solution
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s BEST TEST BANK SOLUTION WITH ALLANSWE
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RS 100%CORRECT 2022 Graded A+
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Joe and Mary are a married couple and both carry insurance from their empl
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oyers. Joe was born on February 23, 1977 and Mary was born on April4, 1974
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. Using the birthday rule, who carries the primary insurance for theirchildren
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for billing?
b b
A. Joe, because he is the male head of the household.
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B. Mary, because her date of birth is the 4th and Joe's date of birth is the 23rd.
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C. Mary, because her birth year is before Joe's birth year.
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D. Joe, because his birth month and day are before Mary's birth month andd
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ay. Correct Answer: D. Joe, because his birth month and day are before Mar
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y's birth month and day.
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Which type of managed care insurance allows patients to self-refer to out-of-
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network providers and pay a higher co-insurance/copay amount?
b b b b b b b b
I. HMO
II. PPO
III. EPO
IV. POS
V. Capitation
A. II
B. IV
AAPC CPB Test Bank Questions with Complete Solution
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s BEST TEST BANK SOLUTION WITH ALLANSWE
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RS 100%CORRECT 2022 Graded A+
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,AAPC CPB Test Bank Questions with Complete Solution
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s BEST TEST BANK SOLUTION WITH ALLANSWE
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RS 100%CORRECT 2022 Graded A+
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C. II and IV b b
D. II, III, and V Correct Answer: C. II and IV
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A patient covered by a PPO is scheduled for knee replacement surgery. Theb
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iller contacts the insurance carrier to verify benefits and preauthorize the pr
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ocedure.
The carrier verifies the patient has a $500 deductible which must be met. Afte
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r the deductible, the PPO will pay 80% of the claim. The contracted ratefor th
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e procedure is $2,500. What is the patient's responsibility?
b b b b b b b b
A. $400 b
B. $500 b
C. $900 b
D. $1,600 Correct Answer: C. $900
b b b b b
AAPC CPB Test Bank Questions with Complete Solution
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s BEST TEST BANK SOLUTION WITH ALLANSWE
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RS 100%CORRECT 2022 Graded A+
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, AAPC CPB Test Bank Questions with Complete Solution
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s BEST TEST BANK SOLUTION WITH ALLANSWE
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RS 100%CORRECT 2022 Graded A+
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When a nonparticipating provider files a claim for a patient to BC/BS, how ist
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he payment processed?
b b
A. The payment is sent to the patient and the patient must pay the provider.
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B. The payment is sent to the provider if the provider agrees to accepta
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ssignment.
C. The payment is sent to the provider regardless if he accepts assignment.
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D. The claim is not paid because the provider is not participating in the plan.C
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orrect Answer: A. The payment is sent to the patient and the patient must pay
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the provider.
b b
Which of the following indicates the frequency of care on a UB-04 claim form?
b b b b b b b b b b b b b
A. Revenue code b
B. Type of Bill b b
C. MSDRG
D. Condition code Correct Answer: B. Type of Bill
b b b b b b b
Pam works for a medical practice. She discovered a claim was overpaid by
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Medicare. What Act requires the money to be refunded?
b b b b b b b b
A. Health Insurance Portability and Accountability Act
b b b b b
B. The Stark Act b b
AAPC CPB Test Bank Questions with Complete Solution
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s BEST TEST BANK SOLUTION WITH ALLANSWE
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RS 100%CORRECT 2022 Graded A+
b b b b
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utions BEST TEST BANK SOLUTION WITH ALLANS
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WERS 100%CORRECT 2022 Graded A+
b b b b
,AAPC CPB Test Bank Questions with Complete Solution
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s BEST TEST BANK SOLUTION WITH ALLANSWE
b b b b b b b
RS 100%CORRECT 2022 Graded A+
b b b b
Joe and Mary are a married couple and both carry insurance from their empl
b b b b b b b b b b b b b
oyers. Joe was born on February 23, 1977 and Mary was born on April4, 1974
b b b b b b b b b b b b b b b
. Using the birthday rule, who carries the primary insurance for theirchildren
b b b b b b b b b b b b
for billing?
b b
A. Joe, because he is the male head of the household.
b b b b b b b b b
B. Mary, because her date of birth is the 4th and Joe's date of birth is the 23rd.
b b b b b b b b b b b b b b b b
C. Mary, because her birth year is before Joe's birth year.
b b b b b b b b b
D. Joe, because his birth month and day are before Mary's birth month andd
b b b b b b b b b b b b b
ay. Correct Answer: D. Joe, because his birth month and day are before Mar
b b b b b b b b b b b b b
y's birth month and day.
b b b b
Which type of managed care insurance allows patients to self-refer to out-of-
b b b b b b b b b b b
network providers and pay a higher co-insurance/copay amount?
b b b b b b b b
I. HMO
II. PPO
III. EPO
IV. POS
V. Capitation
A. II
B. IV
AAPC CPB Test Bank Questions with Complete Solution
b b b b b b b
s BEST TEST BANK SOLUTION WITH ALLANSWE
b b b b b b b
RS 100%CORRECT 2022 Graded A+
b b b b
,AAPC CPB Test Bank Questions with Complete Solution
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s BEST TEST BANK SOLUTION WITH ALLANSWE
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RS 100%CORRECT 2022 Graded A+
b b b b
C. II and IV b b
D. II, III, and V Correct Answer: C. II and IV
b b b b b b b b b
A patient covered by a PPO is scheduled for knee replacement surgery. Theb
b b b b b b b b b b b b b
iller contacts the insurance carrier to verify benefits and preauthorize the pr
b b b b b b b b b b b
ocedure.
The carrier verifies the patient has a $500 deductible which must be met. Afte
b b b b b b b b b b b b b
r the deductible, the PPO will pay 80% of the claim. The contracted ratefor th
b b b b b b b b b b b b b b b
e procedure is $2,500. What is the patient's responsibility?
b b b b b b b b
A. $400 b
B. $500 b
C. $900 b
D. $1,600 Correct Answer: C. $900
b b b b b
AAPC CPB Test Bank Questions with Complete Solution
b b b b b b b
s BEST TEST BANK SOLUTION WITH ALLANSWE
b b b b b b b
RS 100%CORRECT 2022 Graded A+
b b b b
, AAPC CPB Test Bank Questions with Complete Solution
b b b b b b b
s BEST TEST BANK SOLUTION WITH ALLANSWE
b b b b b b b
RS 100%CORRECT 2022 Graded A+
b b b b
When a nonparticipating provider files a claim for a patient to BC/BS, how ist
b b b b b b b b b b b b b b
he payment processed?
b b
A. The payment is sent to the patient and the patient must pay the provider.
b b b b b b b b b b b b b
B. The payment is sent to the provider if the provider agrees to accepta
b b b b b b b b b b b b b
ssignment.
C. The payment is sent to the provider regardless if he accepts assignment.
b b b b b b b b b b b
D. The claim is not paid because the provider is not participating in the plan.C
b b b b b b b b b b b b b b
orrect Answer: A. The payment is sent to the patient and the patient must pay
b b b b b b b b b b b b b b
the provider.
b b
Which of the following indicates the frequency of care on a UB-04 claim form?
b b b b b b b b b b b b b
A. Revenue code b
B. Type of Bill b b
C. MSDRG
D. Condition code Correct Answer: B. Type of Bill
b b b b b b b
Pam works for a medical practice. She discovered a claim was overpaid by
b b b b b b b b b b b b b
Medicare. What Act requires the money to be refunded?
b b b b b b b b
A. Health Insurance Portability and Accountability Act
b b b b b
B. The Stark Act b b
AAPC CPB Test Bank Questions with Complete Solution
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s BEST TEST BANK SOLUTION WITH ALLANSWE
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RS 100%CORRECT 2022 Graded A+
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