National Healthcareer Association
PERP · SCBC
★ ★
NHA Certified Billing & Coding Specialist
CBCS
E X C E L L E N C E I N H E A LT H C A R E C R E D E N T I A L I N G
NHA CBCS Exam Prep — Certified Billing & Coding
Specialist Complete Q&A
B I L L I N G , CO D I N G , I N S U RA N C E , C L A I M S , H I PA A & M E D I C A L T E R M I N O LO G Y
INSTITUTION National Healthcareer Association COURSE CODE CBCS
(NHA)
PROGRAM Certified Billing & Coding ACADEMIC YEAR
Specialist
EXAM TITLE NHA CBCS Exam Prep — Certified TOTAL QUESTIONS 100 Questions
Billing & Coding Specialist
Complete Q&A
COURSE TITLE Certified Billing & Coding FORMAT Multiple Choice — Select the
Specialist Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Topics include billing, coding, insurance, claims processing, HIPAA compliance, medical terminology,
and anatomy.
▸ Correct answers and rationales appear below each question for review purposes.
▸ All content aligns with NHA CBCS exam competencies.
, SECTION I — BILLING, CODING, INSURANCE, CLAIMS,
Questions 1 – 100
HIPAA & MEDICAL TERMINOLOGY
1. Every time a patient is treated by a healthcare provider, a record is made of the encounter.
This record is known as:
A. Documentation
B. Medical record
C. Encounter form
D. Patient chart
CORRECT ANSWER A — Documentation
RATIONALE Documentation is the record made of every patient encounter. It includes all
clinical information, observations, treatments, and services provided during the
patient's care. Documentation is essential for accurate coding, billing, and
continuity of care.
2. What are two pieces of information that need to be collected from patients?
A. Full name and DOB
B. Social Security number and blood type
C. Occupation and education level
D. Marital status and religion
CORRECT ANSWER A — Full name and DOB
RATIONALE Full name and date of birth (DOB) are two essential pieces of information that
need to be collected from patients. These are primary patient identifiers used to
match the patient to their medical records and insurance information, ensuring
accurate and safe care delivery.
,3. What is the verbal or written agreement that gives approval to some action, situation, or
statement, and allows the release of patient information?
A. Authorization
B. Consent agreement
C. Release of information
D. Assignment of benefits
CORRECT ANSWER B — Consent agreement
RATIONALE Consent agreement is the verbal or written agreement that gives approval to
some action, situation, or statement, and allows the release of patient
information. Consent is a fundamental aspect of patient rights and healthcare
privacy.
4. What are HCPCS Level II codes used for?
A. To report physician services
B. To report services, supplies, and procedures not represented in CPT
C. To report inpatient hospital services
D. To report dental services
CORRECT ANSWER B — To report services, supplies, and procedures not represented in CPT
RATIONALE HCPCS Level II codes were established to report services, supplies, and
procedures not represented in CPT. These include durable medical equipment
(DME), ambulance services, prosthetic devices, and other items that are not
covered by CPT codes.
, 5. What is a common coinsurance percentage split?
A. 50% for the insurance carrier and 50% for the patient
B. 70% for the insurance carrier and 30% for the patient
C. 80% for the insurance carrier and 20% for the patient
D. 90% for the insurance carrier and 10% for the patient
CORRECT ANSWER C — 80% for the insurance carrier and 20% for the patient
RATIONALE A common coinsurance percentage split is 80% for the insurance carrier and 20%
for the patient. This means the insurance company pays 80% of the allowed
amount after the deductible is met, and the patient is responsible for the
remaining 20%.
6. Which block on the CMS-1500 claim form is used to accept assignment of benefit?
A. Block 12
B. Block 27
C. Block 31
D. Block 33
CORRECT ANSWER B — Block 27
RATIONALE Block 27 on the CMS-1500 claim form is used to accept assignment of benefits.
The provider checks "Yes" in this block to indicate acceptance of assignment,
agreeing to accept the Medicare-approved amount as payment in full.
PERP · SCBC
★ ★
NHA Certified Billing & Coding Specialist
CBCS
E X C E L L E N C E I N H E A LT H C A R E C R E D E N T I A L I N G
NHA CBCS Exam Prep — Certified Billing & Coding
Specialist Complete Q&A
B I L L I N G , CO D I N G , I N S U RA N C E , C L A I M S , H I PA A & M E D I C A L T E R M I N O LO G Y
INSTITUTION National Healthcareer Association COURSE CODE CBCS
(NHA)
PROGRAM Certified Billing & Coding ACADEMIC YEAR
Specialist
EXAM TITLE NHA CBCS Exam Prep — Certified TOTAL QUESTIONS 100 Questions
Billing & Coding Specialist
Complete Q&A
COURSE TITLE Certified Billing & Coding FORMAT Multiple Choice — Select the
Specialist Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Topics include billing, coding, insurance, claims processing, HIPAA compliance, medical terminology,
and anatomy.
▸ Correct answers and rationales appear below each question for review purposes.
▸ All content aligns with NHA CBCS exam competencies.
, SECTION I — BILLING, CODING, INSURANCE, CLAIMS,
Questions 1 – 100
HIPAA & MEDICAL TERMINOLOGY
1. Every time a patient is treated by a healthcare provider, a record is made of the encounter.
This record is known as:
A. Documentation
B. Medical record
C. Encounter form
D. Patient chart
CORRECT ANSWER A — Documentation
RATIONALE Documentation is the record made of every patient encounter. It includes all
clinical information, observations, treatments, and services provided during the
patient's care. Documentation is essential for accurate coding, billing, and
continuity of care.
2. What are two pieces of information that need to be collected from patients?
A. Full name and DOB
B. Social Security number and blood type
C. Occupation and education level
D. Marital status and religion
CORRECT ANSWER A — Full name and DOB
RATIONALE Full name and date of birth (DOB) are two essential pieces of information that
need to be collected from patients. These are primary patient identifiers used to
match the patient to their medical records and insurance information, ensuring
accurate and safe care delivery.
,3. What is the verbal or written agreement that gives approval to some action, situation, or
statement, and allows the release of patient information?
A. Authorization
B. Consent agreement
C. Release of information
D. Assignment of benefits
CORRECT ANSWER B — Consent agreement
RATIONALE Consent agreement is the verbal or written agreement that gives approval to
some action, situation, or statement, and allows the release of patient
information. Consent is a fundamental aspect of patient rights and healthcare
privacy.
4. What are HCPCS Level II codes used for?
A. To report physician services
B. To report services, supplies, and procedures not represented in CPT
C. To report inpatient hospital services
D. To report dental services
CORRECT ANSWER B — To report services, supplies, and procedures not represented in CPT
RATIONALE HCPCS Level II codes were established to report services, supplies, and
procedures not represented in CPT. These include durable medical equipment
(DME), ambulance services, prosthetic devices, and other items that are not
covered by CPT codes.
, 5. What is a common coinsurance percentage split?
A. 50% for the insurance carrier and 50% for the patient
B. 70% for the insurance carrier and 30% for the patient
C. 80% for the insurance carrier and 20% for the patient
D. 90% for the insurance carrier and 10% for the patient
CORRECT ANSWER C — 80% for the insurance carrier and 20% for the patient
RATIONALE A common coinsurance percentage split is 80% for the insurance carrier and 20%
for the patient. This means the insurance company pays 80% of the allowed
amount after the deductible is met, and the patient is responsible for the
remaining 20%.
6. Which block on the CMS-1500 claim form is used to accept assignment of benefit?
A. Block 12
B. Block 27
C. Block 31
D. Block 33
CORRECT ANSWER B — Block 27
RATIONALE Block 27 on the CMS-1500 claim form is used to accept assignment of benefits.
The provider checks "Yes" in this block to indicate acceptance of assignment,
agreeing to accept the Medicare-approved amount as payment in full.
