4/12/25, 8:24 NHA CBCS CERTIFICATION Flashcards |
PM
NHA CBCS CERTIFICATION EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
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Save
Terms in this set (211)
Which of the following is considered the Adjudication
final determination of the issues involving
settlement of an insurance claim?
A form that contains charges, DOS, CPT Encounter form
codes, ICD codes, fees and copayment
information is called which of the
following?
A patient comes to the hospital for Admitting clerk
an inpatient procedure. Which of the
following hospital staff members is
responsible for the initial patient
interview, obtaining demographic
and insurance information, and
documenting the chief complaint?
Which of the following privacy measures Using data encryption software on office workstations
ensures protected health information
(phi)?
Which of the following planes divides the Sagittal
body into left and right?
Which of the following provisions ensures Coordination of benefits
that an insured's benefits from all
insurance companies do not exceed 100%
of allowable medical expenses?
Which of the following actions should be Verify the age of the account
taken first when reviewing a delinquent
claim?
Which of the following is the advantage Claims are expedited
of electronic claim submission?
Which of the following components of an Claim control number
explanation of benefits expedites the
process of a phone appeal?
The standard medical abbreviation ECG Cardiovascular system
refers to a test used to assess which of the
following body systems?
Which of the following actions by a billing Billing for services not provided
and coding specialist would be
considered fraud?
1/
8
, 4/12/25, 8:24 NHA CBCS CERTIFICATION Flashcards |
PM
The >< symbol is used to indicate a new Procedure descriptors
and revised test other than which of
the following?
On the CMS-1500 claim form, blocks 14 The patient's condition and the provider's information
through 33 contain information about
which of the following?
Which of the following includes Coding Compliance Plan
procedures and best practices for correct
coding?
When completing a CMS-1500 paper Use arial size 10 font
claim form, which of the following is an
acceptable action for the billing and
coding specialist to take?
A participating blue cross/blue shield $48
(BC/BS) provider receives an explanation
of benefits for a patient account. The
charged amount was $100. BC/BS
allowed $80 and applied $40 to the
patient's annual deductible. BC/BS paid
the balance at 80%. How much should
the patient expect to pay?
Which of the following indicates a The claim requires an attachment
claim should be submitted on paper
instead of electronically?
According to HIPAA standards, which NPI
of the following identifies the
rendering provider on the CMS-1500
claim form in block 24j?
Which of the following blocks should Block 24D
the billing and coding specialist
complete on the CMS-1500 claim form
form for procedures, services or
supplies (CPT/HCPCS)?
Which of the following terms describes Coinsurance
when a plan pays 70% of the allowed
amount and the patient pays 30%?
A provider charged $500 to claim that Adjustment column of the credits
had an allowable amount of $400. In
which of the following columns should
the billing and coding specialist apply the
non-allowed charge?
Which of the following is a HIPAA The electronic transmission and code set standards require every provider to use
compliance guideline affecting electronic the healthcare transactions ,code sets and identifiers
health records?
Patient: Jane Austin; Social Security # 555- The DOB is entered incorrectly
22-1111; Medicare ID: 555-33-2222A; DOB:
05/22/1945. Claim information entered:
Austin, Jane; Social Security #.: 555-22-1111;
Medicare ID No.: 555-33-2222A; DOB:
052245. Which of the following is a
reason this claim was rejected?
2/
8
PM
NHA CBCS CERTIFICATION EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
Leave the first rating
Save
Terms in this set (211)
Which of the following is considered the Adjudication
final determination of the issues involving
settlement of an insurance claim?
A form that contains charges, DOS, CPT Encounter form
codes, ICD codes, fees and copayment
information is called which of the
following?
A patient comes to the hospital for Admitting clerk
an inpatient procedure. Which of the
following hospital staff members is
responsible for the initial patient
interview, obtaining demographic
and insurance information, and
documenting the chief complaint?
Which of the following privacy measures Using data encryption software on office workstations
ensures protected health information
(phi)?
Which of the following planes divides the Sagittal
body into left and right?
Which of the following provisions ensures Coordination of benefits
that an insured's benefits from all
insurance companies do not exceed 100%
of allowable medical expenses?
Which of the following actions should be Verify the age of the account
taken first when reviewing a delinquent
claim?
Which of the following is the advantage Claims are expedited
of electronic claim submission?
Which of the following components of an Claim control number
explanation of benefits expedites the
process of a phone appeal?
The standard medical abbreviation ECG Cardiovascular system
refers to a test used to assess which of the
following body systems?
Which of the following actions by a billing Billing for services not provided
and coding specialist would be
considered fraud?
1/
8
, 4/12/25, 8:24 NHA CBCS CERTIFICATION Flashcards |
PM
The >< symbol is used to indicate a new Procedure descriptors
and revised test other than which of
the following?
On the CMS-1500 claim form, blocks 14 The patient's condition and the provider's information
through 33 contain information about
which of the following?
Which of the following includes Coding Compliance Plan
procedures and best practices for correct
coding?
When completing a CMS-1500 paper Use arial size 10 font
claim form, which of the following is an
acceptable action for the billing and
coding specialist to take?
A participating blue cross/blue shield $48
(BC/BS) provider receives an explanation
of benefits for a patient account. The
charged amount was $100. BC/BS
allowed $80 and applied $40 to the
patient's annual deductible. BC/BS paid
the balance at 80%. How much should
the patient expect to pay?
Which of the following indicates a The claim requires an attachment
claim should be submitted on paper
instead of electronically?
According to HIPAA standards, which NPI
of the following identifies the
rendering provider on the CMS-1500
claim form in block 24j?
Which of the following blocks should Block 24D
the billing and coding specialist
complete on the CMS-1500 claim form
form for procedures, services or
supplies (CPT/HCPCS)?
Which of the following terms describes Coinsurance
when a plan pays 70% of the allowed
amount and the patient pays 30%?
A provider charged $500 to claim that Adjustment column of the credits
had an allowable amount of $400. In
which of the following columns should
the billing and coding specialist apply the
non-allowed charge?
Which of the following is a HIPAA The electronic transmission and code set standards require every provider to use
compliance guideline affecting electronic the healthcare transactions ,code sets and identifiers
health records?
Patient: Jane Austin; Social Security # 555- The DOB is entered incorrectly
22-1111; Medicare ID: 555-33-2222A; DOB:
05/22/1945. Claim information entered:
Austin, Jane; Social Security #.: 555-22-1111;
Medicare ID No.: 555-33-2222A; DOB:
052245. Which of the following is a
reason this claim was rejected?
2/
8
