CPB Certified Professional Biller
Certification Practice Exam With Questions
And Correct Verified Answers | 2026/2027
Cycle | Guaranteed Pass | Already Graded
A+ | Brand New !!!!!
Abuse - CORRECTANSWERActions inconsistent with accepted, sound medical business or fiscal
practice
Accept Assignment - CORRECTANSWERProvider accepts as payment in full whatever is paid on
the cliam by the payer (except for any copayment and or coinsurance amounts.)
Accounts Receivable - CORRECTANSWERThe amount owed to a business for services or goods
provided.
Accounts Receivable Aging Report - CORRECTANSWERShows the status (by date) of outstanding
claims from each payer, as well as payments due from patients.
Accounts Receivable Management - CORRECTANSWERAssists Providers in the collection of
appropriate reimbursement for services rendered; include functions such as insurance
verification/eligibility and preauthorization of services.
,Accreditation - CORRECTANSWERVoluntary Process that a healthcare facility or organization
(e.g. hospital or manged care plan) undergoes to demonstarte that it has met standards beyond
those required by law.
Adjudication - CORRECTANSWERJudicial dispuite resolution process in which an appeals board
makes a final determination.
Adjusted Claim - CORRECTANSWERpayment correction resulting in additional payment(s) to the
provider.
Advance Beneficiary Notice (ABN) - CORRECTANSWERDocument that acknowledges patient
responsiblity for payment if Medicare denies the cliam.
Adverse Effect - CORRECTANSWERAlso called adverse reaction; the appearance of a pathologic
condition due to ingestion r exposure to a chemical substance properly administered or taken.
Adverse Reaction - CORRECTANSWERAlso called adverse effect; the appearance of a pathologic
condition due to ingestion r exposure to a chemical substance properly administered or taken.
Adverse Selection - CORRECTANSWERCovering members who are sicker then the general
population.
Allowable Charge - CORRECTANSWERsee limiting charge; maximum fee a physician may charge.
Allowed Charge - CORRECTANSWERThe Maximum amount the payer will reimburse for each
procedure or service, according to the patients policy.
All Patient Diagnosis-Related Group (AP-DRG) - CORRECTANSWERDRG system adapted for use
by third-party payers to reimburse hospitals for inpatient care provided to non-Medicare
, beneficiaries (e.g. Blue Cross Blue Shield, commercial health plans, TRICARE); DRG assignment is
based on intensity of resources.
All Patient Refined Diagnosis-Related Group (ARP-DRG) - CORRECTANSWERAdopted by
Medicare in 2008 to reimburse hospitals for inpatient care provided to Medicare beneficiaries;
expanded originial DRG system (based on intensity of resources) to add two subclasses to each
DRG that adjusts Medicare inpatient hospital reimbursement rates for severity of illness (SOI)
(extent of physiological decompensation or organ system loss of function) and risk of mortality
(ROM) (likelihood of dying); each subclass, in turn, is subdivided into four areas: (1) minor, (2)
moderate, (3) major, (4) extreme.
Ambulance Fee Schedule - CORRECTANSWERPayment system for ambulance services provided
to Medicare Beneficiaries.
Ambulatory Payment Classification (APC) - CORRECTANSWERProspective payment system used
to calculate reimbursement for outpatient care according to similar clinical characteristics and in
terms of resources required.
Ambulatory Surgical Center (ASC) - CORRECTANSWERState Licensed Medicare-certified supplier
(not provider) of surgical healthcare services that must accept assignment on Medicare Claims.
Ambulatory Surgical Center Payment Rate - CORRECTANSWERPredetermined amount for which
ASC services are reimbursed, at 80 percent after adjument for regional wage variations.
Amendment to the HMO Act of 1973 - CORRECTANSWERLegislation that allowed federally
qualified HMOs to permit members to occasionally use non HMO physicians and be partially
reimbursed.
American Academy of Processional Coders (AAPC) - CORRECTANSWERProfessional association
established to provide a national certification and credentialing process, to support the national
Certification Practice Exam With Questions
And Correct Verified Answers | 2026/2027
Cycle | Guaranteed Pass | Already Graded
A+ | Brand New !!!!!
Abuse - CORRECTANSWERActions inconsistent with accepted, sound medical business or fiscal
practice
Accept Assignment - CORRECTANSWERProvider accepts as payment in full whatever is paid on
the cliam by the payer (except for any copayment and or coinsurance amounts.)
Accounts Receivable - CORRECTANSWERThe amount owed to a business for services or goods
provided.
Accounts Receivable Aging Report - CORRECTANSWERShows the status (by date) of outstanding
claims from each payer, as well as payments due from patients.
Accounts Receivable Management - CORRECTANSWERAssists Providers in the collection of
appropriate reimbursement for services rendered; include functions such as insurance
verification/eligibility and preauthorization of services.
,Accreditation - CORRECTANSWERVoluntary Process that a healthcare facility or organization
(e.g. hospital or manged care plan) undergoes to demonstarte that it has met standards beyond
those required by law.
Adjudication - CORRECTANSWERJudicial dispuite resolution process in which an appeals board
makes a final determination.
Adjusted Claim - CORRECTANSWERpayment correction resulting in additional payment(s) to the
provider.
Advance Beneficiary Notice (ABN) - CORRECTANSWERDocument that acknowledges patient
responsiblity for payment if Medicare denies the cliam.
Adverse Effect - CORRECTANSWERAlso called adverse reaction; the appearance of a pathologic
condition due to ingestion r exposure to a chemical substance properly administered or taken.
Adverse Reaction - CORRECTANSWERAlso called adverse effect; the appearance of a pathologic
condition due to ingestion r exposure to a chemical substance properly administered or taken.
Adverse Selection - CORRECTANSWERCovering members who are sicker then the general
population.
Allowable Charge - CORRECTANSWERsee limiting charge; maximum fee a physician may charge.
Allowed Charge - CORRECTANSWERThe Maximum amount the payer will reimburse for each
procedure or service, according to the patients policy.
All Patient Diagnosis-Related Group (AP-DRG) - CORRECTANSWERDRG system adapted for use
by third-party payers to reimburse hospitals for inpatient care provided to non-Medicare
, beneficiaries (e.g. Blue Cross Blue Shield, commercial health plans, TRICARE); DRG assignment is
based on intensity of resources.
All Patient Refined Diagnosis-Related Group (ARP-DRG) - CORRECTANSWERAdopted by
Medicare in 2008 to reimburse hospitals for inpatient care provided to Medicare beneficiaries;
expanded originial DRG system (based on intensity of resources) to add two subclasses to each
DRG that adjusts Medicare inpatient hospital reimbursement rates for severity of illness (SOI)
(extent of physiological decompensation or organ system loss of function) and risk of mortality
(ROM) (likelihood of dying); each subclass, in turn, is subdivided into four areas: (1) minor, (2)
moderate, (3) major, (4) extreme.
Ambulance Fee Schedule - CORRECTANSWERPayment system for ambulance services provided
to Medicare Beneficiaries.
Ambulatory Payment Classification (APC) - CORRECTANSWERProspective payment system used
to calculate reimbursement for outpatient care according to similar clinical characteristics and in
terms of resources required.
Ambulatory Surgical Center (ASC) - CORRECTANSWERState Licensed Medicare-certified supplier
(not provider) of surgical healthcare services that must accept assignment on Medicare Claims.
Ambulatory Surgical Center Payment Rate - CORRECTANSWERPredetermined amount for which
ASC services are reimbursed, at 80 percent after adjument for regional wage variations.
Amendment to the HMO Act of 1973 - CORRECTANSWERLegislation that allowed federally
qualified HMOs to permit members to occasionally use non HMO physicians and be partially
reimbursed.
American Academy of Processional Coders (AAPC) - CORRECTANSWERProfessional association
established to provide a national certification and credentialing process, to support the national
