CPB PRACTICE EXAM (45 QUESTIONS) WITH
VERIFIED ANSWERS
WHO IS COVERED BY CHAMPVA?
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES
B) ACTIVE DUTY MILITARY AND THEIR FAMILIES
C) RETIRED MILITARY AND THEIR FAMILIES
,D) ACTIVE DUTY MILITARY OVER THE AGE OF 65 - A) VETERANS WITH SERVICE - CONNECTED
DISABILITIES AND THEIR FAMILIES
RATIONALE: THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF
VETERANS AFFAIRS (CHAMPVA) COVERS VETERANS WHO ARE PERMANENTLY AND TOTALLY
DISABLED DUE TO A SERVICE-RELATED DISABILITY AND THEIR SPOUSE AND CHILDREN.
PATIENT IS BROUGHT TO THE LOCAL URGENT CARE AFTER FALLING FROM A LADDER WHILE
HANGING EXTERIOR LIGHTS ON HIS HOUSE. X-RAYS REVEALED A CLOSED FRACTURE OF HIS
LEFT FEMUR. THE PATIENT IS COVERED BY HIS EMPLOYER'S GROUP HEALTH PLAN AND HE
ALSO HAS A HOMEOWNER'S LIABILITY INSURANCE POLICY. WHICH INSURANCE SHOULD BE
BILLED?
A) THE HOMEOWNER'S INSURANCE FIRST, FOLLOWED BY THE GROUP HEALTH PLAN
B) THE EMPLOYER'S GROUP HEALTH PLAN
C) THE HOMEOWNER'S INSURANCE ONLY
D) FILE THE EMPLOYER'S GROUP HEALTH PLAN AS PRIMARY AND LIST THE HOMEOWNER'S
INSURANCE AS SECONDARY. - B) THE EMPLOYER'S GROUP HEALTH PLAN
RATIONALE: THE HEALTH INSURANCE PLAN IS BILLED FIRST AND THEN THROUGH THE
PROCESS OF SUBROGATION IT WILL BE DETERMINED IF A LIABILITY PAYER SHOULD BE
CONSIDERED PRIMARY.
3. PRIVATE COMPANIES CONTRACT WITH CMS TO ADMINISTER:
A) MEDICARE PART A & B
B) MEDICARE PART B
C) MEDICARE PART C
D) MEDICARE PART A, B, & C - D) MEDICARE PART A, B, AND C
, RATIONALE: MEDICARE PART A, B, AND C ARE ALL ADMINISTERED BY PRIVATE COMPANIES
THAT CONTRACT WITH CMS AS MEDICARE ADMINISTRATIVE CONTRACTORS OR MACs.
WHAT IS A CO-PAYMENT?
A) AN AMOUNT PAID EVERY MONTH BY THE POLICYHOLDER TO MAINTAIN HEALTH INSURANCE
COVERAGE
B) A PERCENTAGE OF THE ALLOWED AMOUNT THAT THE PATIENT IS RESPONSIBLE FOR.
C) A FLAT AMOUNT PAID TO THE HEALTHCARE PROVIDER WHEN THE POLICYHOLDER IS SEEN
FOR AN OFFICE VISIT.
D) THE ADJUSTED AMOUNT BASED ON THE INSURANCE POLICY REQUIREMENT. - C) A FLAT
AMOUNT PAID TO THE HEALTHCARE PROVIDER WHEN THE POLICY HOLDER IS SEEN FOR AN
OFFICE VISIT.
WHICH OF THE FOLLOWING STATEMENTS IS TRUE REGARDING THE NON-PAR MEDICARE
ALLOWED FEE SCHEDULE?
A) THE NON-PAR PROVIDER CAN BILL THE PATIENT THE DIFFERENCE BETWEEN THE
CHARGE AND THE MEDICARE ALLOWABLE.
B) THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-PAR MEDICARE PHYSICIAN FEE
SCHEDULE
C) THE NON-PAR PHYSICIAN FEE SCHEDULE IS 115% OF THE PAR MEDICARE PHYSICIAN
FEE SCHEDULE
D) THE NON-PAR LIMITING CHARGE IS 95% OF THE PAR MEDICARE PHYSICIAN FEE
SCHEDULE. - B) THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-PAR MEDICARE
PHYSICIAN FEE SCHEDULE.
RATIONALE: PER CMS, THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-PAR MEDICARE
PHYSICIAN FEE SCHEDULE.
WHAT IS A MEDIGAP POLICY?
VERIFIED ANSWERS
WHO IS COVERED BY CHAMPVA?
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES
B) ACTIVE DUTY MILITARY AND THEIR FAMILIES
C) RETIRED MILITARY AND THEIR FAMILIES
,D) ACTIVE DUTY MILITARY OVER THE AGE OF 65 - A) VETERANS WITH SERVICE - CONNECTED
DISABILITIES AND THEIR FAMILIES
RATIONALE: THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF
VETERANS AFFAIRS (CHAMPVA) COVERS VETERANS WHO ARE PERMANENTLY AND TOTALLY
DISABLED DUE TO A SERVICE-RELATED DISABILITY AND THEIR SPOUSE AND CHILDREN.
PATIENT IS BROUGHT TO THE LOCAL URGENT CARE AFTER FALLING FROM A LADDER WHILE
HANGING EXTERIOR LIGHTS ON HIS HOUSE. X-RAYS REVEALED A CLOSED FRACTURE OF HIS
LEFT FEMUR. THE PATIENT IS COVERED BY HIS EMPLOYER'S GROUP HEALTH PLAN AND HE
ALSO HAS A HOMEOWNER'S LIABILITY INSURANCE POLICY. WHICH INSURANCE SHOULD BE
BILLED?
A) THE HOMEOWNER'S INSURANCE FIRST, FOLLOWED BY THE GROUP HEALTH PLAN
B) THE EMPLOYER'S GROUP HEALTH PLAN
C) THE HOMEOWNER'S INSURANCE ONLY
D) FILE THE EMPLOYER'S GROUP HEALTH PLAN AS PRIMARY AND LIST THE HOMEOWNER'S
INSURANCE AS SECONDARY. - B) THE EMPLOYER'S GROUP HEALTH PLAN
RATIONALE: THE HEALTH INSURANCE PLAN IS BILLED FIRST AND THEN THROUGH THE
PROCESS OF SUBROGATION IT WILL BE DETERMINED IF A LIABILITY PAYER SHOULD BE
CONSIDERED PRIMARY.
3. PRIVATE COMPANIES CONTRACT WITH CMS TO ADMINISTER:
A) MEDICARE PART A & B
B) MEDICARE PART B
C) MEDICARE PART C
D) MEDICARE PART A, B, & C - D) MEDICARE PART A, B, AND C
, RATIONALE: MEDICARE PART A, B, AND C ARE ALL ADMINISTERED BY PRIVATE COMPANIES
THAT CONTRACT WITH CMS AS MEDICARE ADMINISTRATIVE CONTRACTORS OR MACs.
WHAT IS A CO-PAYMENT?
A) AN AMOUNT PAID EVERY MONTH BY THE POLICYHOLDER TO MAINTAIN HEALTH INSURANCE
COVERAGE
B) A PERCENTAGE OF THE ALLOWED AMOUNT THAT THE PATIENT IS RESPONSIBLE FOR.
C) A FLAT AMOUNT PAID TO THE HEALTHCARE PROVIDER WHEN THE POLICYHOLDER IS SEEN
FOR AN OFFICE VISIT.
D) THE ADJUSTED AMOUNT BASED ON THE INSURANCE POLICY REQUIREMENT. - C) A FLAT
AMOUNT PAID TO THE HEALTHCARE PROVIDER WHEN THE POLICY HOLDER IS SEEN FOR AN
OFFICE VISIT.
WHICH OF THE FOLLOWING STATEMENTS IS TRUE REGARDING THE NON-PAR MEDICARE
ALLOWED FEE SCHEDULE?
A) THE NON-PAR PROVIDER CAN BILL THE PATIENT THE DIFFERENCE BETWEEN THE
CHARGE AND THE MEDICARE ALLOWABLE.
B) THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-PAR MEDICARE PHYSICIAN FEE
SCHEDULE
C) THE NON-PAR PHYSICIAN FEE SCHEDULE IS 115% OF THE PAR MEDICARE PHYSICIAN
FEE SCHEDULE
D) THE NON-PAR LIMITING CHARGE IS 95% OF THE PAR MEDICARE PHYSICIAN FEE
SCHEDULE. - B) THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-PAR MEDICARE
PHYSICIAN FEE SCHEDULE.
RATIONALE: PER CMS, THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-PAR MEDICARE
PHYSICIAN FEE SCHEDULE.
WHAT IS A MEDIGAP POLICY?
