NHA Certified Billing and Coding
Specialist (CBCS) Exam| Latest
Update % Success(A+)
What is the role of the accounts receivable department? - ANSWER✔✔The
accounts receivable department manages follow-up to the billing process
for a provider's office.
What are two kinds of information the CDM(charge description master)
stores? - ANSWER✔✔Among the correct responses are description of
service, CPT/HCPCS code, revenue code, charge amount, charge or
service code, general ledger key, and activity/status date.
An aging report refers to what? - ANSWER✔✔Aging reports refer to the
paid or unpaid status of invoices. (the claims that are outstanding, it usually
organized in 30 days increments)
True or False
An RA is sent to policyholders - ANSWER✔✔False: An RA is sent to the
provider, not to policyholders
The allowable charge is which of the following? - ANSWER✔✔amount the
health insurance company will pay providers. (the allowable charge, also
called allowable fee, maximum fee, maximum allowable, usual-reasonable-
customary, URC charge or prevailing rate, is the amount the insurer
actually pay.
,what is not a charge patient is expected to pay? - ANSWER✔✔difference
between a provider's charges and what the insurance company will pay
(write-offs are the amount a provider agrees to accept as payment minus
deductibles, copayments and coinsurance)
The term reconciliation means? - ANSWER✔✔Determining how much the
provider has been reimbursed and how much patients owe
(refers to the process the billing office goes through to determine what
payments have come in from the third-party payer and what the patient
owes the provider. the billing office uses the RA, EBO, and MSN to make
these determinations.)
What are the four types of nonmedical codes used by medicare to explain
claims? - ANSWER✔✔1. Group codes
2. claims adjustment reason codes (CARCs)
3. remittance advice remark (RARC's)
4. Provider-level adjustment reason codes are not related to a specific
claim (these adjustments are made by provider's office)
Who benefits from the new appeals process and why? - ANSWER✔✔The
patient benefits because the new process lays out steps the insurance
company must follow and makes sure that the tasks get done in a timely
manner fashion
, When can a patient request an external independent review? -
ANSWER✔✔The patient can request an external independent review after
an internal appeal has been denied.
What kind of information does CDM(charge description master) has? -
ANSWER✔✔all the information about health care services that patients
have received and financial transactions that have taken place.
What is the main purpose of the CDM (charge description master)? -
ANSWER✔✔to make sere that the provider accurately charges the patient
for routine services and supplies.
Medicare Summary Notice (MSN) - ANSWER✔✔Document that outlines
the amounts billed by the provider and what the patient must pay the
provider. (are sent to medicare patient)
The ICD-10-CM was developed by - ANSWER✔✔Centers for Disease
Control and Prevention
ICD-10-PCS was developed by - ANSWER✔✔Centers for Medicare and
Medicaid Services (CMS) and will be used only in US hospitals
ICD-9-CM is made up of three volumes - ANSWER✔✔volume 1: tabular list
of diseases and injuries
volume 2: the alphabetic index to diseases and injuries
volume 3: the classification for procedures for reporting hospital procedures
Specialist (CBCS) Exam| Latest
Update % Success(A+)
What is the role of the accounts receivable department? - ANSWER✔✔The
accounts receivable department manages follow-up to the billing process
for a provider's office.
What are two kinds of information the CDM(charge description master)
stores? - ANSWER✔✔Among the correct responses are description of
service, CPT/HCPCS code, revenue code, charge amount, charge or
service code, general ledger key, and activity/status date.
An aging report refers to what? - ANSWER✔✔Aging reports refer to the
paid or unpaid status of invoices. (the claims that are outstanding, it usually
organized in 30 days increments)
True or False
An RA is sent to policyholders - ANSWER✔✔False: An RA is sent to the
provider, not to policyholders
The allowable charge is which of the following? - ANSWER✔✔amount the
health insurance company will pay providers. (the allowable charge, also
called allowable fee, maximum fee, maximum allowable, usual-reasonable-
customary, URC charge or prevailing rate, is the amount the insurer
actually pay.
,what is not a charge patient is expected to pay? - ANSWER✔✔difference
between a provider's charges and what the insurance company will pay
(write-offs are the amount a provider agrees to accept as payment minus
deductibles, copayments and coinsurance)
The term reconciliation means? - ANSWER✔✔Determining how much the
provider has been reimbursed and how much patients owe
(refers to the process the billing office goes through to determine what
payments have come in from the third-party payer and what the patient
owes the provider. the billing office uses the RA, EBO, and MSN to make
these determinations.)
What are the four types of nonmedical codes used by medicare to explain
claims? - ANSWER✔✔1. Group codes
2. claims adjustment reason codes (CARCs)
3. remittance advice remark (RARC's)
4. Provider-level adjustment reason codes are not related to a specific
claim (these adjustments are made by provider's office)
Who benefits from the new appeals process and why? - ANSWER✔✔The
patient benefits because the new process lays out steps the insurance
company must follow and makes sure that the tasks get done in a timely
manner fashion
, When can a patient request an external independent review? -
ANSWER✔✔The patient can request an external independent review after
an internal appeal has been denied.
What kind of information does CDM(charge description master) has? -
ANSWER✔✔all the information about health care services that patients
have received and financial transactions that have taken place.
What is the main purpose of the CDM (charge description master)? -
ANSWER✔✔to make sere that the provider accurately charges the patient
for routine services and supplies.
Medicare Summary Notice (MSN) - ANSWER✔✔Document that outlines
the amounts billed by the provider and what the patient must pay the
provider. (are sent to medicare patient)
The ICD-10-CM was developed by - ANSWER✔✔Centers for Disease
Control and Prevention
ICD-10-PCS was developed by - ANSWER✔✔Centers for Medicare and
Medicaid Services (CMS) and will be used only in US hospitals
ICD-9-CM is made up of three volumes - ANSWER✔✔volume 1: tabular list
of diseases and injuries
volume 2: the alphabetic index to diseases and injuries
volume 3: the classification for procedures for reporting hospital procedures
