National Healthcareer Association
MAXE · SCBC
★ ★
NHA NHA Certification Exams
EST. 1989
A D VA N C I N G H E A LT H C A R E C A R E E RS T H R O U G H C E RT I F I C AT I O N
NHA CBCS Exam Flashcards
C E RT I F I E D B I L L I N G & CO D I N G S P E C I A L I ST
INSTITUTION National Healthcareer Association COURSE CODE CBCS
(NHA)
PROGRAM Certified Billing & Coding ACADEMIC YEAR
Specialist
EXAM TITLE NHA CBCS Exam Flashcards TOTAL QUESTIONS 60 Questions
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.
▸ Medical billing, coding, insurance terminology, and healthcare regulations are all testable content.
▸ Key terms and definitions from the CBCS exam are emphasized throughout.
▸ Correct answers and detailed rationales appear below each question for exam review.
▸ All content reflects current NHA CBCS exam standards.
, SECTION I — CBCS EXAM REVIEW Questions 1 – 60
1. What is the difference between fraud and abuse in healthcare billing?
A. Fraud is intentional misrepresentation; Abuse is unintentional poor business practices
B. Fraud is unintentional; Abuse is intentional
C. Fraud involves overpayments; Abuse involves underpayments
D. Fraud and abuse are the same thing
CORRECT ANSWER A — Fraud is intentional misrepresentation; Abuse is unintentional poor
business practices
RATIONALE Fraud involves intentionally misrepresenting services rendered for the purpose of
receiving a higher payment. Abuse refers to practices that are often done
unknowingly as a result of poor business practices, directly or indirectly resulting
in unnecessary costs to the program through improper payments.
2. What does the Fair Debt Collection Practices Act say debt collectors can't do?
A. Use unfair or abusive practices to collect a debt
B. Contact debtors at any time
C. Collect debts over $500
D. Use automated calling systems
CORRECT ANSWER A — Use unfair or abusive practices to collect a debt
RATIONALE The Fair Debt Collection Practices Act prohibits debt collectors from using unfair
or abusive practices to collect a debt. This includes harassment, false statements,
and unfair practices designed to intimidate or mislead consumers.
,3. What are the parts of Medicare A, B, C, and D?
A. A - Hospitalization/Inpatient; B - Outpatient/Professional Services; C - Medicare
Advantage Plans; D - Drug Coverage
B. A - Outpatient; B - Inpatient; C - Drug Coverage; D - Medicare Advantage
C. A - Drug Coverage; B - Hospitalization; C - Outpatient; D - Medicare Advantage
D. A - Medicare Advantage; B - Drug Coverage; C - Hospitalization; D - Outpatient
CORRECT ANSWER A — A - Hospitalization/Inpatient; B - Outpatient/Professional Services; C -
Medicare Advantage Plans; D - Drug Coverage
RATIONALE Medicare Part A covers hospitalization/inpatient services. Part B covers
outpatient/physician/professional services. Part C refers to Medicare Advantage
Plans. Part D provides prescription drug coverage. This is the standard breakdown
of Medicare's four parts.
4. What is an aging report?
A. Identifies the outstanding balances in each account in 30-day increments
B. A report that lists all patients by age
C. A list of expired insurance policies
D. A report of denied claims
CORRECT ANSWER A — Identifies the outstanding balances in each account in 30-day
increments
RATIONALE An aging report identifies the outstanding balances in each account, maintained
in 30-day increments. It helps medical billing staff track how long accounts have
been overdue and prioritize collection efforts on the oldest accounts.
, 5. What is the difference between a Remittance Advice and Explanation of Benefits?
A. Remittance Advice is sent to the provider; Explanation of Benefits is sent to the patient
B. Remittance Advice is sent to the patient; Explanation of Benefits is sent to the provider
C. They are the same document
D. Remittance Advice is for Medicare; Explanation of Benefits is for Medicaid
CORRECT ANSWER A — Remittance Advice is sent to the provider; Explanation of Benefits is
sent to the patient
RATIONALE A Remittance Advice is the breakdown of payments and denials sent from the
third-party payer to the provider. An Explanation of Benefits contains the same
information but is sent to the patient to explain what was covered and what the
patient owes.
6. What does block 33 on the CMS-1500 claim form indicate?
A. The billing information (either the servicing provider's info or a third-party billing
company)
B. The patient's signature
C. The diagnosis codes
D. The date of service
CORRECT ANSWER A — The billing information (either the servicing provider's info or a third-
party billing company)
RATIONALE Block 33 on the CMS-1500 claim form indicates the billing information. This can
be either the servicing provider's information or a third-party billing company's
information, depending on who is submitting the claim for payment.
MAXE · SCBC
★ ★
NHA NHA Certification Exams
EST. 1989
A D VA N C I N G H E A LT H C A R E C A R E E RS T H R O U G H C E RT I F I C AT I O N
NHA CBCS Exam Flashcards
C E RT I F I E D B I L L I N G & CO D I N G S P E C I A L I ST
INSTITUTION National Healthcareer Association COURSE CODE CBCS
(NHA)
PROGRAM Certified Billing & Coding ACADEMIC YEAR
Specialist
EXAM TITLE NHA CBCS Exam Flashcards TOTAL QUESTIONS 60 Questions
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.
▸ Medical billing, coding, insurance terminology, and healthcare regulations are all testable content.
▸ Key terms and definitions from the CBCS exam are emphasized throughout.
▸ Correct answers and detailed rationales appear below each question for exam review.
▸ All content reflects current NHA CBCS exam standards.
, SECTION I — CBCS EXAM REVIEW Questions 1 – 60
1. What is the difference between fraud and abuse in healthcare billing?
A. Fraud is intentional misrepresentation; Abuse is unintentional poor business practices
B. Fraud is unintentional; Abuse is intentional
C. Fraud involves overpayments; Abuse involves underpayments
D. Fraud and abuse are the same thing
CORRECT ANSWER A — Fraud is intentional misrepresentation; Abuse is unintentional poor
business practices
RATIONALE Fraud involves intentionally misrepresenting services rendered for the purpose of
receiving a higher payment. Abuse refers to practices that are often done
unknowingly as a result of poor business practices, directly or indirectly resulting
in unnecessary costs to the program through improper payments.
2. What does the Fair Debt Collection Practices Act say debt collectors can't do?
A. Use unfair or abusive practices to collect a debt
B. Contact debtors at any time
C. Collect debts over $500
D. Use automated calling systems
CORRECT ANSWER A — Use unfair or abusive practices to collect a debt
RATIONALE The Fair Debt Collection Practices Act prohibits debt collectors from using unfair
or abusive practices to collect a debt. This includes harassment, false statements,
and unfair practices designed to intimidate or mislead consumers.
,3. What are the parts of Medicare A, B, C, and D?
A. A - Hospitalization/Inpatient; B - Outpatient/Professional Services; C - Medicare
Advantage Plans; D - Drug Coverage
B. A - Outpatient; B - Inpatient; C - Drug Coverage; D - Medicare Advantage
C. A - Drug Coverage; B - Hospitalization; C - Outpatient; D - Medicare Advantage
D. A - Medicare Advantage; B - Drug Coverage; C - Hospitalization; D - Outpatient
CORRECT ANSWER A — A - Hospitalization/Inpatient; B - Outpatient/Professional Services; C -
Medicare Advantage Plans; D - Drug Coverage
RATIONALE Medicare Part A covers hospitalization/inpatient services. Part B covers
outpatient/physician/professional services. Part C refers to Medicare Advantage
Plans. Part D provides prescription drug coverage. This is the standard breakdown
of Medicare's four parts.
4. What is an aging report?
A. Identifies the outstanding balances in each account in 30-day increments
B. A report that lists all patients by age
C. A list of expired insurance policies
D. A report of denied claims
CORRECT ANSWER A — Identifies the outstanding balances in each account in 30-day
increments
RATIONALE An aging report identifies the outstanding balances in each account, maintained
in 30-day increments. It helps medical billing staff track how long accounts have
been overdue and prioritize collection efforts on the oldest accounts.
, 5. What is the difference between a Remittance Advice and Explanation of Benefits?
A. Remittance Advice is sent to the provider; Explanation of Benefits is sent to the patient
B. Remittance Advice is sent to the patient; Explanation of Benefits is sent to the provider
C. They are the same document
D. Remittance Advice is for Medicare; Explanation of Benefits is for Medicaid
CORRECT ANSWER A — Remittance Advice is sent to the provider; Explanation of Benefits is
sent to the patient
RATIONALE A Remittance Advice is the breakdown of payments and denials sent from the
third-party payer to the provider. An Explanation of Benefits contains the same
information but is sent to the patient to explain what was covered and what the
patient owes.
6. What does block 33 on the CMS-1500 claim form indicate?
A. The billing information (either the servicing provider's info or a third-party billing
company)
B. The patient's signature
C. The diagnosis codes
D. The date of service
CORRECT ANSWER A — The billing information (either the servicing provider's info or a third-
party billing company)
RATIONALE Block 33 on the CMS-1500 claim form indicates the billing information. This can
be either the servicing provider's information or a third-party billing company's
information, depending on who is submitting the claim for payment.
