CBCS PRACTICE TEST l Fully solved 2023

1. Missing #1 - CORRECT ANS BLANK 2. A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - CORRECT ANS INVALID 3. Medigap coverage is offered to Medicare beneficiaries by? - CORRECT ANS PRIVATE THIRD-PARTY PAYER 4. This provision ensures that an insured's benefits from all insurance companies does not exceed 100% of allowable medical - CORRECT ANS Coordination of benefits 5. A coroner's autopsy is comprised of which examination? - CORRECT ANS Gross examination. 6. This statement is true regarding the release of patient records? - CORRECT ANS Patient access to psychotherapy notes may be restricted. 7. Actions by a billing & coding specialist would be considered fraud? - CORRECT ANS Billing for services not provided. 8. The components of an explanation of benefits expedites the process of a phone appeal? - CORRECT ANS Claim control number. 9. On the CMS-1500 claim form, blocks 14 through 33 contain information of?. - CORRECT ANS The patient's condition & the provider's information 10. A billing & coding specialist should understand that the financial record source that is generated by a provider's office is called a? - CORRECT ANS Patient Ledger Account. 11. The medical terms refer to the sac that endoses the heart? - CORRECT ANS Pericardium. 12. HIPAA transaction standards apply to? - CORRECT ANS Health care clearinghouse. 13. All dependents 10 years of age or older are required to have which of the following for TRICARE? - CORRECT ANS Military identification. 14. The standard medical abbreviation "ECG" refers to a test used to assess? - CORRECT ANS Cardiovascular system. 15. An example of a violation of an adult patient's confidentiality? - CORRECT ANS Patient information was disclosed to the patient's parent without consent. 16. Claims that are submitted without an NPI number will delay payment to the provider because? - CORRECT ANS the number is needed to identify the provider 17. Sections of the medical record is used to determine the correct Evaluation & Management code used for billing & coding? - CORRECT ANS History & physical 18. Actions should be taken if an insurance company denies a service as not medically necessary? - CORRECT ANS Appeal the decision with a provider's report. 19. Missing #19 - CORRECT ANS misssing 20. The function of the respiratory system? - CORRECT ANS Oxygenating blood cells 21. This describes a delinquent claim? - CORRECT ANS The claim is overdue for payment. 22. What actions should the billing & coding specialist take if he observes a colleague in an unethical situation? - CORRECT ANS Report the incident to a supervisor. 23. A participating Blue Cross/Blue Shield (BC/BS) provider receives an explanation of benefits for a patient account. The charged amount was $100. BC/BS allowed $80 & applied $40 to the patient's annual deductible. BC/BS paid the balance at 80%. How much should the patient expect to pay? - CORRECT ANS $48. 24. This statement is correct regarding a deductible? - CORRECT ANS The deductible is the patient's responsibility. 25. A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has Medicare as her primary insurance. This form is required so the patient knows she may be responsible for payment? - CORRECT ANS Advance Beneficiary Notice. 26. What is the purpose of precertification? - CORRECT ANS Verification of coverage.