4/12/25, 8:25 NHA CBCS Exam Prep Flashcards |
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NHA CBCS EXAM PREP QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS
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Terms in this set (128)
What actions should be taken when a Submit an appeal with documentation
claim is billed for a level four office
visit and paid at a level three?
The standard medical abbreviation "ECG" cardiovascular system- test checks electricity of heart
refers to a test used to assess which of the
body systems?
According to HIPAA standards, what NPI
identifies the rendering provider on the
CMS-1500 claim form in Block 24J?
On the CMS-1500 claim form, blocks 14 The patient's condition and the provider's information
through 33 contain information about?
Which block should the BCS complete 24D
on the CMS-1500 form for procedures,
services, or supplies?
Which term describes when a plan pays Coinsurance is a percentage of the cost for covered services that is approved by
70% of the allowed and the patient the insurance company
pays 30%?
A provider charges $500 to a claim that Write Off or adjustment
had an allowable amount of $400.
What should happen to the non-
allowed
charge?
Patient: Justin Austin; Social Security NO.: The DOB is entered incorrectly - the format is two digits for the month and four
555-22-1111; Medicare ID NO.: 555-33- digits for the year.
2222A; DOB: 05/22/1945. Claim
information entered: Austin, Jane; Social
Security No.: 555-22-111; Medicare ID No.:
555-33-2222A; DOB: 052245. What is a
reason the claim was rejected?
A patient's health plan is referred to as Medicaid
the "payer of last resort." The patient
is
covered by which health plan?
The physician bills $500 to a patient. After Deductible
submitting the claim to the insurance
company, the claim is sent back with
no payment. The patient still owes $500
for the year. This amount is called
what?
Ambulatory surgery centers, home UB-04 Form
health care, and hospice organizations
use what form?
1/
5
, 4/12/25, 8:25 NHA CBCS Exam Prep Flashcards |
PM
A physician ordered a comprehensive Advanced Beneficiary Notice is a form that is required for Medicare recipients
metabolic panel for a 70-year-old patient
who has Medicare as her primary
insurance. Which form is required so the
patient knows she may be responsible for
payment?
Which of the following should the BCS CMS-1500 claim form
complete to be reimbursed for the
provider's services?
What is the maximum number of 12
diagnoses that can be reported on the
CMS-1500 claim form before a further
claim is required?
Describe a delinquent claim? It is considered delinquent when it is overdue for payment, 120 days or older
What are considered proper supportive Operative reports are required to support surgical procedures
documentation for reporting CPT and ICD
codes for surgical procedures?
When submitting a clean claim with a Nephrolithiasis The destruction of kidney stones
diagnosis of kidney stones, which of the
following procedure names is correct?
The BCS should first divide the e/m code Place of service which narrows down the specific code as one of the three
by which of the following? deciding factors
Appeal the decision with a provider's Which of the following actions should be taken if an insurance company denies a
report service as not medically necessary?
Which departments should a patient Dermatology, related to the integumentary system which includes hair, skin, and
be seen for psoriasis? And what body nails
system is involved?
Which block requires the patient's Block 12
authorization to release medical
information to process a claim?
What is the purpose of precertification? Verification of Coverage
A provider performs an examination of a Problem-focused examination is a specific examination of an affected organ.
patient's sore throat during an office
visit.
What describes the level of the
examination?
What is the verbal or written agreement Consent agreement
that gives approval to some action,
situation, or statement, and allows the
release of patient information?
On the CMS-1500 claim form, blocks 1 The patient's demographics are found in Blocks 2,3,5, and 7
through 13 include what information?
What is the main function of the Oxygenating blood cells
respiratory system?
Which section of the medical record is History and physical
used to determine the correct E/M code
used for billings and coding?
The parent whose birthday comes first in the calendar year is the Primary
Describe the birthday rule.
Insurance.
2/
5
PM
NHA CBCS EXAM PREP QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS
Leave the first rating
Save
Terms in this set (128)
What actions should be taken when a Submit an appeal with documentation
claim is billed for a level four office
visit and paid at a level three?
The standard medical abbreviation "ECG" cardiovascular system- test checks electricity of heart
refers to a test used to assess which of the
body systems?
According to HIPAA standards, what NPI
identifies the rendering provider on the
CMS-1500 claim form in Block 24J?
On the CMS-1500 claim form, blocks 14 The patient's condition and the provider's information
through 33 contain information about?
Which block should the BCS complete 24D
on the CMS-1500 form for procedures,
services, or supplies?
Which term describes when a plan pays Coinsurance is a percentage of the cost for covered services that is approved by
70% of the allowed and the patient the insurance company
pays 30%?
A provider charges $500 to a claim that Write Off or adjustment
had an allowable amount of $400.
What should happen to the non-
allowed
charge?
Patient: Justin Austin; Social Security NO.: The DOB is entered incorrectly - the format is two digits for the month and four
555-22-1111; Medicare ID NO.: 555-33- digits for the year.
2222A; DOB: 05/22/1945. Claim
information entered: Austin, Jane; Social
Security No.: 555-22-111; Medicare ID No.:
555-33-2222A; DOB: 052245. What is a
reason the claim was rejected?
A patient's health plan is referred to as Medicaid
the "payer of last resort." The patient
is
covered by which health plan?
The physician bills $500 to a patient. After Deductible
submitting the claim to the insurance
company, the claim is sent back with
no payment. The patient still owes $500
for the year. This amount is called
what?
Ambulatory surgery centers, home UB-04 Form
health care, and hospice organizations
use what form?
1/
5
, 4/12/25, 8:25 NHA CBCS Exam Prep Flashcards |
PM
A physician ordered a comprehensive Advanced Beneficiary Notice is a form that is required for Medicare recipients
metabolic panel for a 70-year-old patient
who has Medicare as her primary
insurance. Which form is required so the
patient knows she may be responsible for
payment?
Which of the following should the BCS CMS-1500 claim form
complete to be reimbursed for the
provider's services?
What is the maximum number of 12
diagnoses that can be reported on the
CMS-1500 claim form before a further
claim is required?
Describe a delinquent claim? It is considered delinquent when it is overdue for payment, 120 days or older
What are considered proper supportive Operative reports are required to support surgical procedures
documentation for reporting CPT and ICD
codes for surgical procedures?
When submitting a clean claim with a Nephrolithiasis The destruction of kidney stones
diagnosis of kidney stones, which of the
following procedure names is correct?
The BCS should first divide the e/m code Place of service which narrows down the specific code as one of the three
by which of the following? deciding factors
Appeal the decision with a provider's Which of the following actions should be taken if an insurance company denies a
report service as not medically necessary?
Which departments should a patient Dermatology, related to the integumentary system which includes hair, skin, and
be seen for psoriasis? And what body nails
system is involved?
Which block requires the patient's Block 12
authorization to release medical
information to process a claim?
What is the purpose of precertification? Verification of Coverage
A provider performs an examination of a Problem-focused examination is a specific examination of an affected organ.
patient's sore throat during an office
visit.
What describes the level of the
examination?
What is the verbal or written agreement Consent agreement
that gives approval to some action,
situation, or statement, and allows the
release of patient information?
On the CMS-1500 claim form, blocks 1 The patient's demographics are found in Blocks 2,3,5, and 7
through 13 include what information?
What is the main function of the Oxygenating blood cells
respiratory system?
Which section of the medical record is History and physical
used to determine the correct E/M code
used for billings and coding?
The parent whose birthday comes first in the calendar year is the Primary
Describe the birthday rule.
Insurance.
2/
5
