4/12/25, 8:27 NHA CBCS Baseline Practice Test Flashcards |
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NHA CBCS BASELINE PRACTICE TEST EXAM QUESTIONS
AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
LATEST UPDATE GRADED A++
Leave the first rating
Save
Terms in this set (117)
A billing and coding specialist is TRICARE
collecting demographic information for
a patient who lives in Hawaii and is an
active duty service member. The specialist
should identify that the insured has which
of the following types of insurance?
- TRICARE Prime Overseas
- TRICARE for Life
- TRICARE Reserve Select
- TRICARE
A billing and coding specialist is Include an attachment
submitting an electronic claim for a
procedure with modifier -22 for increased
procedural services. Which of the
following actions should the specialist
take?
A billing and coding specialist is Send the patient an itemized statement to collect the outstanding balance
reviewing a patient's account and notes
there is an outstanding balance that is 45
days old after third-party payer
reimbursement. Which of the following
actions should the specialist take?
Which of the following does a patient sign Assignment of benefits statement
to allow payment of claims directly to
the provider?
The HIPPA Privacy Rule requires covered Release protected health information (PHI)
entities to track which of the following?
A billing and coding specialist is Remove all information other than what pertains to the patient
contacted by a patient who requests a
copy of the remittance advice for a
recently adjudicated claim. Which of the
following actions should the specialist
take?
A billing and coding specialist is - Charged amount-payment amount-adjustment amount=patient responsibility
posting payments from an explanation of
benefits (EOB). Which of the following
equations determines how patient
responsibility is
calculated?
1/11
, 4/12/25, 8:27 NHA CBCS Baseline Practice Test Flashcards |
PM
A patient has managed care insurance Remove all other information other than what pertains to the patient
and has been referred to a specialist for
gastric bypass surgery. Which of the
following is needed to ensure payment?
A patient has a managed care Preauthorization
insurance and has been referred to a
specialist for gastric bypass surgery.
Which of the
following is needed to ensure payment?
Which of the following security features is Encryption
required during transmission of protected
health information and medical claims to
third party payers?
HCPCS codes are used in which of Physician clinics
the following health care settings?
A billing and coding specialist is They are responsible for any charges that are incurred
performing a coordination of benefits
check. the patient has primary and
secondary benefits which of the following
applies to the guarantor?
Which of the following processes is used Recertification
to verify patient benefits and
insurance coverage for an outpatient
procedure?
A billing and coding specialist is Submitting claims, translating them to a standard format, then sending them to
submitting claims through a various third-party payers
clearinghouse. The specialist should
identify that which of the following
actions is performed by the
clearinghouse?
A billing and coding specialist is The CID-10-CM code for tonsillitis was listed with the CPT code for an
reviewing a remittance advice for a claim appendectomy.
that was denied for medical necessity.
Which of the following is an example of
this type of error?
A patient is covered by Medicare through Part C
managed care. Which of the following
parts of Medicare includes this coverage?
Which of the following documents should Aging report
a billing and coding specialist use to
ensure that all payers are sending
reimbursement within 45 days of claim
submission?
A provider orders a comprehensive Advance Beneficiary Notice
metabolic panel for a 70-year-old patient
who has Medicare as their primary
insurance. Which of the following is
required to inform the patient they may
be responsible for payment?
2/11
PM
NHA CBCS BASELINE PRACTICE TEST EXAM QUESTIONS
AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
LATEST UPDATE GRADED A++
Leave the first rating
Save
Terms in this set (117)
A billing and coding specialist is TRICARE
collecting demographic information for
a patient who lives in Hawaii and is an
active duty service member. The specialist
should identify that the insured has which
of the following types of insurance?
- TRICARE Prime Overseas
- TRICARE for Life
- TRICARE Reserve Select
- TRICARE
A billing and coding specialist is Include an attachment
submitting an electronic claim for a
procedure with modifier -22 for increased
procedural services. Which of the
following actions should the specialist
take?
A billing and coding specialist is Send the patient an itemized statement to collect the outstanding balance
reviewing a patient's account and notes
there is an outstanding balance that is 45
days old after third-party payer
reimbursement. Which of the following
actions should the specialist take?
Which of the following does a patient sign Assignment of benefits statement
to allow payment of claims directly to
the provider?
The HIPPA Privacy Rule requires covered Release protected health information (PHI)
entities to track which of the following?
A billing and coding specialist is Remove all information other than what pertains to the patient
contacted by a patient who requests a
copy of the remittance advice for a
recently adjudicated claim. Which of the
following actions should the specialist
take?
A billing and coding specialist is - Charged amount-payment amount-adjustment amount=patient responsibility
posting payments from an explanation of
benefits (EOB). Which of the following
equations determines how patient
responsibility is
calculated?
1/11
, 4/12/25, 8:27 NHA CBCS Baseline Practice Test Flashcards |
PM
A patient has managed care insurance Remove all other information other than what pertains to the patient
and has been referred to a specialist for
gastric bypass surgery. Which of the
following is needed to ensure payment?
A patient has a managed care Preauthorization
insurance and has been referred to a
specialist for gastric bypass surgery.
Which of the
following is needed to ensure payment?
Which of the following security features is Encryption
required during transmission of protected
health information and medical claims to
third party payers?
HCPCS codes are used in which of Physician clinics
the following health care settings?
A billing and coding specialist is They are responsible for any charges that are incurred
performing a coordination of benefits
check. the patient has primary and
secondary benefits which of the following
applies to the guarantor?
Which of the following processes is used Recertification
to verify patient benefits and
insurance coverage for an outpatient
procedure?
A billing and coding specialist is Submitting claims, translating them to a standard format, then sending them to
submitting claims through a various third-party payers
clearinghouse. The specialist should
identify that which of the following
actions is performed by the
clearinghouse?
A billing and coding specialist is The CID-10-CM code for tonsillitis was listed with the CPT code for an
reviewing a remittance advice for a claim appendectomy.
that was denied for medical necessity.
Which of the following is an example of
this type of error?
A patient is covered by Medicare through Part C
managed care. Which of the following
parts of Medicare includes this coverage?
Which of the following documents should Aging report
a billing and coding specialist use to
ensure that all payers are sending
reimbursement within 45 days of claim
submission?
A provider orders a comprehensive Advance Beneficiary Notice
metabolic panel for a 70-year-old patient
who has Medicare as their primary
insurance. Which of the following is
required to inform the patient they may
be responsible for payment?
2/11
