NHA MBC PREPARATION EXAM QUESTIONS AND ANSWERS
Which of the following is considered the final determination of the issues involving settlement of an
insurance claim?
-Processing
-Translation
-Adjudication
-Transmission - CORRECT ANSWERS✅✅Adjudication
Adjudication - CORRECT ANSWERS✅✅the process of putting an insurance claim through a series of
edits for final determination.
A form that contains charges, DOS, CPT codes, ICD codes, fees, and copayment information.
-Encounter form
-Itemized bill
-Chargemaster
-Remittance advice - CORRECT ANSWERS✅✅Encounter form
Encounter form - CORRECT ANSWERS✅✅a form that contains charges, DOS, CPT codes, ICD codes, fees
and copayment information.
A patient comes to the hospital for 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?
-Nurse
-Insurance billing clerk
-Admitting clerk
-Ward clerk - CORRECT ANSWERS✅✅Admitting clerk
Admitting clerk - CORRECT ANSWERS✅✅These duties are the responsibility.
,Which of the following privacy measures ensures protected health information (PHI)?
-Confirming test results with the patient over the phone at the reception area.
-Asking patients the reason for their visit during check-in
-Using data encryption software on office workstations.
-Calling patients into the clinical area using first and last name. - CORRECT ANSWERS✅✅Using data
encryption software on office workstations.
Using data encryption software on office workstations. - CORRECT ANSWERS✅✅Encryption software
ensures that electronically transmitted health information cannot be read by third parties. This privacy
measure guarantees PHI.
Which of the following planes divides the body into left and right?
-Sagittal
-Coronal
-Transverse
-Distal - CORRECT ANSWERS✅✅Sagittal
Sagittal - CORRECT ANSWERS✅✅The sagittal plan divides the body into right and left sections.
Coronal - CORRECT ANSWERS✅✅the coronal plane divides the body into anterior and posterior.
Transverse - CORRECT ANSWERS✅✅the transverse plane divides the body into superior and inferior
portions.
Distal - CORRECT ANSWERS✅✅Farthest away from the origin.
Which of the following provisions ensures that an insured's benefits from all insurance companies do
not exceed 100% of allowable medical expenses?
-Source document
-Assignment of benefits
, -Coinsurance
-Coordination of benefits - CORRECT ANSWERS✅✅Coordination of benefits
Coordination of benefits - CORRECT ANSWERS✅✅ensures that the insured benefits from all insured
companies do not exceed 100% of allowable medical expenses.
Which of the following actions should be taken first when reviewing a delinquent claim?
-Verify the age of the account
-Query the insurance company
-Obtain claim status
-Resubmit the claim - CORRECT ANSWERS✅✅Verify the age of the account.
Verifying the age of the account - CORRECT ANSWERS✅✅the account is the first action the billing and
coding specialist should take.
Which of the following is the advantage of electronic claim submission?
-Claims are expedited
-Claims are scrubbed
-Claims are clean
-Claims are paid - CORRECT ANSWERS✅✅Claims are expedited
Claims are expedited - CORRECT ANSWERS✅✅Submitting claims electronically is faster than submitting
paper claims.
Which of the following components of an explanation of benefits expedites the process of a phone
appeal?
-NPI number
-Claim control number
-Insured's ID number
-Check number - CORRECT ANSWERS✅✅Claim control number
Which of the following is considered the final determination of the issues involving settlement of an
insurance claim?
-Processing
-Translation
-Adjudication
-Transmission - CORRECT ANSWERS✅✅Adjudication
Adjudication - CORRECT ANSWERS✅✅the process of putting an insurance claim through a series of
edits for final determination.
A form that contains charges, DOS, CPT codes, ICD codes, fees, and copayment information.
-Encounter form
-Itemized bill
-Chargemaster
-Remittance advice - CORRECT ANSWERS✅✅Encounter form
Encounter form - CORRECT ANSWERS✅✅a form that contains charges, DOS, CPT codes, ICD codes, fees
and copayment information.
A patient comes to the hospital for 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?
-Nurse
-Insurance billing clerk
-Admitting clerk
-Ward clerk - CORRECT ANSWERS✅✅Admitting clerk
Admitting clerk - CORRECT ANSWERS✅✅These duties are the responsibility.
,Which of the following privacy measures ensures protected health information (PHI)?
-Confirming test results with the patient over the phone at the reception area.
-Asking patients the reason for their visit during check-in
-Using data encryption software on office workstations.
-Calling patients into the clinical area using first and last name. - CORRECT ANSWERS✅✅Using data
encryption software on office workstations.
Using data encryption software on office workstations. - CORRECT ANSWERS✅✅Encryption software
ensures that electronically transmitted health information cannot be read by third parties. This privacy
measure guarantees PHI.
Which of the following planes divides the body into left and right?
-Sagittal
-Coronal
-Transverse
-Distal - CORRECT ANSWERS✅✅Sagittal
Sagittal - CORRECT ANSWERS✅✅The sagittal plan divides the body into right and left sections.
Coronal - CORRECT ANSWERS✅✅the coronal plane divides the body into anterior and posterior.
Transverse - CORRECT ANSWERS✅✅the transverse plane divides the body into superior and inferior
portions.
Distal - CORRECT ANSWERS✅✅Farthest away from the origin.
Which of the following provisions ensures that an insured's benefits from all insurance companies do
not exceed 100% of allowable medical expenses?
-Source document
-Assignment of benefits
, -Coinsurance
-Coordination of benefits - CORRECT ANSWERS✅✅Coordination of benefits
Coordination of benefits - CORRECT ANSWERS✅✅ensures that the insured benefits from all insured
companies do not exceed 100% of allowable medical expenses.
Which of the following actions should be taken first when reviewing a delinquent claim?
-Verify the age of the account
-Query the insurance company
-Obtain claim status
-Resubmit the claim - CORRECT ANSWERS✅✅Verify the age of the account.
Verifying the age of the account - CORRECT ANSWERS✅✅the account is the first action the billing and
coding specialist should take.
Which of the following is the advantage of electronic claim submission?
-Claims are expedited
-Claims are scrubbed
-Claims are clean
-Claims are paid - CORRECT ANSWERS✅✅Claims are expedited
Claims are expedited - CORRECT ANSWERS✅✅Submitting claims electronically is faster than submitting
paper claims.
Which of the following components of an explanation of benefits expedites the process of a phone
appeal?
-NPI number
-Claim control number
-Insured's ID number
-Check number - CORRECT ANSWERS✅✅Claim control number
