NHA CBCS CERTIFICATION Exam l Fully solved 2023

Which of the following is considered the final determination of the issues involving settlement of an insurance claim? - CORRECT ANSWER Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information is called which of the following? - CORRECT ANSWER Encounter form A patient comes to the hospital for an inpatient procedure. Which of the following hospital staff members is responsible for the initial patient interview, obtaining demographic and insurance information, and documenting the chief complaint? - CORRECT ANSWER Admitting clerk Which of the following privacy measures ensures protected health information (phi)? - CORRECT ANSWER Using data encryption software on office workstations Which of the following planes divides the body into left and right? - CORRECT ANSWER Sagittal Which of the following provisions ensures that an insured's benefits from all insurance companies do not exceed 100% of allowable medical expenses? - CORRECT ANSWER Coordination of benefits Which of the following actions should be taken first when reviewing a delinquent claim? - CORRECT ANSWER Verify the age of the account Which of the following is the advantage of electronic claim submission? - CORRECT ANSWER Claims are expedited Which of the following components of an explanation of benefits expedites the process of a phone appeal? - CORRECT ANSWER Claim control number The standard medical abbreviation ECG refers to a test used to assess which of the following body systems? - CORRECT ANSWER Cardiovascular system Which of the following actions by a billing and coding specialist would be considered fraud? - CORRECT ANSWER Billing for services not provided The >< symbol is used to indicate a new and revised test other than which of the following? - CORRECT ANSWER Procedure descriptors On the CMS-1500 claim form, blocks 14 through 33 contain information about which of the following? - CORRECT ANSWER The patient's condition and the provider's information Which of the following includes procedures and best practices for correct coding? - CORRECT ANSWER Coding Compliance Plan When completing a CMS-1500 paper claim form, which of the following is an acceptable action for the billing and coding specialist to take? - CORRECT ANSWER Use arial size 10 font 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 and applied $40 to the patient's annual deductible. BC/BS paid the balance at 80%. How much should the patient expect to pay? - CORRECT ANSWER $48 Which of the following indicates a claim should be submitted on paper instead of electronically? - CORRECT ANSWER The claim requires an attachment According to HIPAA standards, which of the following identifies the rendering provider on the CMS-1500 claim form in block 24j? - CORRECT ANSWER NPI Which of the following blocks should the billing and coding specialist complete on the CMS-1500 claim form form for procedures, services or supplies (CPT/HCPCS)? - CORRECT ANSWER Block 24D Which of the following terms describes when a plan pays 70% of the allowed amount and the patient pays 30%? - CORRECT ANSWER Coinsurance