AAPC CPB EXAMS SCRIPT 2027 ALL ANSWERS AND
QUESTIONS SET A+
✔✔Which Act protects information collected by consumer reporting agencies? - ✔✔Fair
Credit Reporting Act
✔✔A plan where a provider accepts a fixed, pre-established monthly payment for
enrollees in a health insurance plan - ✔✔capitated
✔✔Deadline for filing Medicare claim - ✔✔1 year
✔✔billing a patient for the difference between what the insurance paid and the total
amount the doctor's office billed for - ✔✔balance bill
✔✔PA billling for E/M uses ___ guidelines - ✔✔1995 or 1997
✔✔"with contrast" does not include ___ contrast (for CT Scan) - ✔✔oral, rectal
✔✔Billing for a higher E/M service than the documentation indicates is considered ___ -
✔✔fraud
✔✔person bringing civil action for FCA violation for themselves - ✔✔qui tam relator
✔✔An example of a non-mid level provider - ✔✔resident
✔✔accounts receivable that cannot be collected by the provider or a collection agency.
- ✔✔bad debt
✔✔Prompt payment act requires clean claims be paid/denied within ___ of receipt -
✔✔30 days
, ✔✔non participants in Medicare who see a Medicare patient can bill ___% of Medicare
fee schedule - ✔✔115
✔✔accounts that have not been paid within a certain time frame and should be turned
over to a collection agency - ✔✔deliquent
✔✔Not included in hospital chargemaster - ✔✔diagnosis codes
✔✔CMS reuires to file this with claims - ✔✔routing slip, superbill, encounter form,
charge slip
✔✔CRNA service, without medical direction by a physician - ✔✔QZ
✔✔CMS develops LCD's when there is no NCD - ✔✔False
✔✔Tricare that is most similar to an HMO - ✔✔Prime
✔✔CMS preceding to insurer ID on line 9a - ✔✔Medigap, MG
✔✔CPT and HCPSCS Level II code(s) on UB-04 are translated into ___ code for
Medicare reimbursement - ✔✔APC
✔✔E/M service not recognized by Medicare - ✔✔consultation codes
✔✔daily deposits mean balancing ___ receipts - ✔✔mail, personal payment
✔✔When a physician does not accept Medicare and pt elects to go anyway. Medicare
will send pt the limiting charge for the services provided in order for them to pay most of
their bill - ✔✔unassigned
✔✔ Health plan, clearinghouses, and any entity transmitting health information is
considered by the Privacy Rule to be a: - ✔✔covered entity
✔✔Which of the following is not a covered entity in the Privacy Rule - ✔✔healthcare
consulting firm
✔✔A request for medical records is received for a specific date of service from patient's
insurance company with regards to a submitted claim. No authorization for release of
information is provided. What action should be taken? - ✔✔release reqt to ins co
✔✔How many national priority purposes under the Privacy Rules for disclosure of
specific PHI without an individual's authorization or permission? - ✔✔12
QUESTIONS SET A+
✔✔Which Act protects information collected by consumer reporting agencies? - ✔✔Fair
Credit Reporting Act
✔✔A plan where a provider accepts a fixed, pre-established monthly payment for
enrollees in a health insurance plan - ✔✔capitated
✔✔Deadline for filing Medicare claim - ✔✔1 year
✔✔billing a patient for the difference between what the insurance paid and the total
amount the doctor's office billed for - ✔✔balance bill
✔✔PA billling for E/M uses ___ guidelines - ✔✔1995 or 1997
✔✔"with contrast" does not include ___ contrast (for CT Scan) - ✔✔oral, rectal
✔✔Billing for a higher E/M service than the documentation indicates is considered ___ -
✔✔fraud
✔✔person bringing civil action for FCA violation for themselves - ✔✔qui tam relator
✔✔An example of a non-mid level provider - ✔✔resident
✔✔accounts receivable that cannot be collected by the provider or a collection agency.
- ✔✔bad debt
✔✔Prompt payment act requires clean claims be paid/denied within ___ of receipt -
✔✔30 days
, ✔✔non participants in Medicare who see a Medicare patient can bill ___% of Medicare
fee schedule - ✔✔115
✔✔accounts that have not been paid within a certain time frame and should be turned
over to a collection agency - ✔✔deliquent
✔✔Not included in hospital chargemaster - ✔✔diagnosis codes
✔✔CMS reuires to file this with claims - ✔✔routing slip, superbill, encounter form,
charge slip
✔✔CRNA service, without medical direction by a physician - ✔✔QZ
✔✔CMS develops LCD's when there is no NCD - ✔✔False
✔✔Tricare that is most similar to an HMO - ✔✔Prime
✔✔CMS preceding to insurer ID on line 9a - ✔✔Medigap, MG
✔✔CPT and HCPSCS Level II code(s) on UB-04 are translated into ___ code for
Medicare reimbursement - ✔✔APC
✔✔E/M service not recognized by Medicare - ✔✔consultation codes
✔✔daily deposits mean balancing ___ receipts - ✔✔mail, personal payment
✔✔When a physician does not accept Medicare and pt elects to go anyway. Medicare
will send pt the limiting charge for the services provided in order for them to pay most of
their bill - ✔✔unassigned
✔✔ Health plan, clearinghouses, and any entity transmitting health information is
considered by the Privacy Rule to be a: - ✔✔covered entity
✔✔Which of the following is not a covered entity in the Privacy Rule - ✔✔healthcare
consulting firm
✔✔A request for medical records is received for a specific date of service from patient's
insurance company with regards to a submitted claim. No authorization for release of
information is provided. What action should be taken? - ✔✔release reqt to ins co
✔✔How many national priority purposes under the Privacy Rules for disclosure of
specific PHI without an individual's authorization or permission? - ✔✔12
