National Healthcareer Association
MAXE · SCBC
Certified Billing & Coding Specialist
NHA
EST. 1989
A D V A N C I N G H E A LT H C A R E C A R E E R S
NHA CBCS — Certified Billing and Coding Specialist
Exam
M E D I C A L B I L L I N G & CO D I N G C E RT I F I C AT I O N
INSTITUTION National Healthcareer Association CERTIFICATION CBCS — Certified Billing & Coding
Specialist
PROGRAM Medical Billing & Coding ACADEMIC YEAR
EXAM TITLE NHA CBCS — Certified Billing and TOTAL QUESTIONS 53 Questions
Coding Specialist Exam
COURSE TITLE Certified Billing & Coding FORMAT Multiple Choice — Select the
Specialist Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ Billing and coding terminology, claims processing, and compliance regulations are all testable content.
▸ Insurance concepts, coding systems, and documentation standards are emphasized.
▸ Correct answers and rationales appear below each question for review purposes.
▸ All content reflects the NHA CBCS certification exam curriculum.
, SECTION I — MEDICAL BILLING, CODING & COMPLIANCE Questions 1 – 53
1. What does SOAP stand for in medical documentation?
A. Subjective, Objective, Assessment, Plan
B. Symptoms, Observations, Analysis, Prescription
C. Subjective, Operational, Assessment, Procedure
D. Summary, Objective, Analysis, Progress
CORRECT ANSWER A — Subjective, Objective, Assessment, Plan
RATIONALE SOAP is a method of documentation used by healthcare providers to document
progress notes in a patient's chart. It stands for Subjective, Objective,
Assessment, and Plan.
2. What does the abbreviation ABN stand for?
A. Advanced Beneficiary Notice of noncoverage
B. Annual Benefit Notification
C. Allowed Benefit Number
D. Approved Beneficiary Notice
CORRECT ANSWER A — Advanced Beneficiary Notice of noncoverage
RATIONALE ABN stands for Advanced Beneficiary Notice of noncoverage. It is a notice given to
Medicare beneficiaries before certain services are rendered when the provider
believes Medicare may not cover them.
, 3. What is the allowed amount?
A. The amount the patient is responsible for paying
B. The maximum amount an insurance company will pay for a procedure, service or supply
C. The total cost of services before insurance
D. The deductible amount
CORRECT ANSWER B — The maximum amount an insurance company will pay for a procedure,
service or supply
RATIONALE The allowed amount is the maximum amount an insurance company will pay for
a covered procedure, service, or supply. It is also known as the allowable charge
or negotiated rate.
4. What is a denied claim?
A. A claim that has been paid in full
B. A claim returned from a third-party payer because of technical errors or patient coverage
errors
C. A claim that is pending review
D. A claim that has been approved for payment
CORRECT ANSWER B — A claim returned from a third-party payer because of technical errors
or patient coverage errors
RATIONALE A denied claim is returned from a third-party payer due to technical errors,
missing information, or patient coverage issues. Denied claims must be corrected
and resubmitted.
MAXE · SCBC
Certified Billing & Coding Specialist
NHA
EST. 1989
A D V A N C I N G H E A LT H C A R E C A R E E R S
NHA CBCS — Certified Billing and Coding Specialist
Exam
M E D I C A L B I L L I N G & CO D I N G C E RT I F I C AT I O N
INSTITUTION National Healthcareer Association CERTIFICATION CBCS — Certified Billing & Coding
Specialist
PROGRAM Medical Billing & Coding ACADEMIC YEAR
EXAM TITLE NHA CBCS — Certified Billing and TOTAL QUESTIONS 53 Questions
Coding Specialist Exam
COURSE TITLE Certified Billing & Coding FORMAT Multiple Choice — Select the
Specialist Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ Billing and coding terminology, claims processing, and compliance regulations are all testable content.
▸ Insurance concepts, coding systems, and documentation standards are emphasized.
▸ Correct answers and rationales appear below each question for review purposes.
▸ All content reflects the NHA CBCS certification exam curriculum.
, SECTION I — MEDICAL BILLING, CODING & COMPLIANCE Questions 1 – 53
1. What does SOAP stand for in medical documentation?
A. Subjective, Objective, Assessment, Plan
B. Symptoms, Observations, Analysis, Prescription
C. Subjective, Operational, Assessment, Procedure
D. Summary, Objective, Analysis, Progress
CORRECT ANSWER A — Subjective, Objective, Assessment, Plan
RATIONALE SOAP is a method of documentation used by healthcare providers to document
progress notes in a patient's chart. It stands for Subjective, Objective,
Assessment, and Plan.
2. What does the abbreviation ABN stand for?
A. Advanced Beneficiary Notice of noncoverage
B. Annual Benefit Notification
C. Allowed Benefit Number
D. Approved Beneficiary Notice
CORRECT ANSWER A — Advanced Beneficiary Notice of noncoverage
RATIONALE ABN stands for Advanced Beneficiary Notice of noncoverage. It is a notice given to
Medicare beneficiaries before certain services are rendered when the provider
believes Medicare may not cover them.
, 3. What is the allowed amount?
A. The amount the patient is responsible for paying
B. The maximum amount an insurance company will pay for a procedure, service or supply
C. The total cost of services before insurance
D. The deductible amount
CORRECT ANSWER B — The maximum amount an insurance company will pay for a procedure,
service or supply
RATIONALE The allowed amount is the maximum amount an insurance company will pay for
a covered procedure, service, or supply. It is also known as the allowable charge
or negotiated rate.
4. What is a denied claim?
A. A claim that has been paid in full
B. A claim returned from a third-party payer because of technical errors or patient coverage
errors
C. A claim that is pending review
D. A claim that has been approved for payment
CORRECT ANSWER B — A claim returned from a third-party payer because of technical errors
or patient coverage errors
RATIONALE A denied claim is returned from a third-party payer due to technical errors,
missing information, or patient coverage issues. Denied claims must be corrected
and resubmitted.
