MEDICAL BILLING & CODING
CERTIFICATION EXAM QUESTIONS AND
VERIFIED ANSWERS 2026
▶ What are the two types of billing in medical billing? Answer: Facility
billing and professional billing.
▶ What is facility billing? Answer: Charging for services done in hospitals,
skilled nursing facilities, rehabilitation centers, or ambulatory surgical
centers.
▶ What is professional billing? Answer: Charging for services performed by
physicians or non-physician practitioners (NPPs).
▶ What does NPP stand for? Answer: Non-Physician Practitioner.
▶ What are some examples of NPPs? Answer: Physician assistants, nurse
practitioners, and certified nurse anesthetists.
▶ What is revenue cycle management? Answer: The process of managing
the financial aspects of a health care organization to ensure cash flow.
▶ What is the average cost range for an uncomplicated vaginal delivery
today? Answer: Between $5,000 and $11,000.
▶ What is the average cost range for a cesarean birth? Answer: Between
$7,500 and $14,500.
▶ What skills are essential for an insurance billing specialist? Answer:
Perseverance, determination, strong computer skills, and coding
proficiency.
▶ What are electronic medical records? Answer: Digital versions of
patients' paper charts, used by health care providers.
, ▶ What are personal health records? Answer: Records managed by
patients that include their health information such as diagnoses and
medications.
▶ What is the importance of accurate charge entry in billing? Answer: It
ensures timely billing and reimbursement for services rendered.
▶ What must billing specialists be familiar with regarding insurance
payers? Answer: Each payer's guidelines and reimbursement methods.
▶ What is the role of the charge entry staff member? Answer: To ensure
the correct charge is assigned to the correct patient.
▶ What is the significance of the flow of information between departments
in a health care organization? Answer: It is vital for the overall revenue
cycle and operational efficiency.
▶ What does the term 'encounter' refer to in medical billing? Answer: An
interaction between a patient and a health care provider.
▶ What is the role of bookkeeping in medical billing? Answer: To post
payments and manage patients' financial accounts.
▶ What are remittance advices? Answer: Documents received from
insurance payers detailing payments and adjustments.
▶ What is the impact of laws and regulations on the health care billing
industry? Answer: They create a heavily regulated environment that billing
specialists must navigate.
▶ What is the historical context of medical billing charges? Answer:
Charges have significantly increased and become more complex over time.
▶ What is the role of an insurance billing specialist in relation to health care
providers? Answer: To handle the complex billing processes and ensure
compliance with regulations.
CERTIFICATION EXAM QUESTIONS AND
VERIFIED ANSWERS 2026
▶ What are the two types of billing in medical billing? Answer: Facility
billing and professional billing.
▶ What is facility billing? Answer: Charging for services done in hospitals,
skilled nursing facilities, rehabilitation centers, or ambulatory surgical
centers.
▶ What is professional billing? Answer: Charging for services performed by
physicians or non-physician practitioners (NPPs).
▶ What does NPP stand for? Answer: Non-Physician Practitioner.
▶ What are some examples of NPPs? Answer: Physician assistants, nurse
practitioners, and certified nurse anesthetists.
▶ What is revenue cycle management? Answer: The process of managing
the financial aspects of a health care organization to ensure cash flow.
▶ What is the average cost range for an uncomplicated vaginal delivery
today? Answer: Between $5,000 and $11,000.
▶ What is the average cost range for a cesarean birth? Answer: Between
$7,500 and $14,500.
▶ What skills are essential for an insurance billing specialist? Answer:
Perseverance, determination, strong computer skills, and coding
proficiency.
▶ What are electronic medical records? Answer: Digital versions of
patients' paper charts, used by health care providers.
, ▶ What are personal health records? Answer: Records managed by
patients that include their health information such as diagnoses and
medications.
▶ What is the importance of accurate charge entry in billing? Answer: It
ensures timely billing and reimbursement for services rendered.
▶ What must billing specialists be familiar with regarding insurance
payers? Answer: Each payer's guidelines and reimbursement methods.
▶ What is the role of the charge entry staff member? Answer: To ensure
the correct charge is assigned to the correct patient.
▶ What is the significance of the flow of information between departments
in a health care organization? Answer: It is vital for the overall revenue
cycle and operational efficiency.
▶ What does the term 'encounter' refer to in medical billing? Answer: An
interaction between a patient and a health care provider.
▶ What is the role of bookkeeping in medical billing? Answer: To post
payments and manage patients' financial accounts.
▶ What are remittance advices? Answer: Documents received from
insurance payers detailing payments and adjustments.
▶ What is the impact of laws and regulations on the health care billing
industry? Answer: They create a heavily regulated environment that billing
specialists must navigate.
▶ What is the historical context of medical billing charges? Answer:
Charges have significantly increased and become more complex over time.
▶ What is the role of an insurance billing specialist in relation to health care
providers? Answer: To handle the complex billing processes and ensure
compliance with regulations.
