CBCS PRACTICE EXAM #3
Aoopatientoopresentsootoootheooprovideroowithoochestoopainooandooshortnessooofoobreath.o
oAfterooanoounexpectedooECGooresult,ootheooprovideroocallsooaoocardiologistooandoosumm
arizesootheoopatient'soosymptoms.ooWhatooportionooofooHIPAAooallowsootheooproviderootoo
ospeakootoootheoocardiologistoopriorootoooobtainingootheoopatient'sooconsent?oo-ooans--
TitleooII
Aoophysicianooisoocontractedoowithooanooinsuranceoocompanyootoooacceptootheooallowedoo
amount.ooTheooinsuranceoocompanyooallowsoo$80ooofooaoo$120oobilledooamount,ooandoo$
50ooofootheoodeductibleoohasoonotoobeenoomet.ooHowoomuchooshouldootheoophysicianoowri
teoooffootheoopatient'sooaccount?oo-ooans--$40
Whichooofootheoofollowingoosectionsooofootheoomedicaloorecordooisoousedootooodetermineoo
theoocorrectooEvaluationooandooManagementoocodeoousedooforoobillingooandoocoding?oo-
ooans--Historyooandoophysical
AoobillingooandoocodingoospecialistooisooreviewingooaooCMS-
1500ooclaimooform.ooTheooassignmentooofoobenefitsooboxoohasoobeenoocheckedooyes.ooT
heoocheckedooboxooindicatesoowhichooofootheoofollowing?oo-ooans--
Theooproviderooreceivesoopaymentoodirectlyoofromootheoopayer.
Whichooofootheoofollowingoodooophysiciansoouseootoooelectronicallyoosubmitooclaims?oo-
ooans--Clearinghouse
Whichooofootheoofollowingooshouldootheoobillingooandoocodingoospecialistooincludeooinooano
oauthorizationootoooreleaseooinformation?oo-ooans--
Theooentityootooowhomootheooinformationooisootooobeooreleased
Whichooofootheoofollowingoodescribesootheoocontentooofooaoomedicaloopracticeooagingoorep
ort?oo-ooans--Anoooverviewooofootheoopractice'soooutstandingooclaims
HIPAAootransactionoostandardsooapplyootooowhichooofootheoofollowingooentities?oo-ooans--
Healthoocareooclearinghouses
Whenooaoophysicianoodocumentsooaoopatient'sooresponseootooosymptomsooandoovariouso
obodyoosystems,ootheooresultsooareoodocumentedooasoowhichooofootheoofollowing?oo-
ooans--Reviewooofoosystems
, WhichoopartooofooMedicareoocoversooprescriptions?oo-ooans--PartooD
Whichooofootheoofollowingooindicatesooaooclaimooshouldoobeoosubmittedooonoopaperooinste
adooofooelectronically?oo-ooans--Theooclaimoorequiresooanooattachment.
Medicareooenforcesoomandatoryoosubmissionooofooelectronicooclaimsooforoomostooprovide
rs.ooWhichooofootheoofollowingooprovidersooisooallowedootooosubmitoopaperooclaimsootoooM
edicare?oo-ooans--Aooprovider'sooofficeoowithoofeweroothanoo10oofull-timeooemployees
Whichooofootheoofollowingooisootheoocorrectootermooforooanooamountoothatoohasoobeenoodet
erminedootooobeoouncollectable?oo-ooans--Badoodebt
Whichooofootheoofollowingoostatementsooisoocorrectooregardingooaoodeductible?oo-ooans--
Theoodeductibleooisootheoopatient'sooresponsibility.
Whichooofootheoofollowingoostatementsooisootrueooregardingootheooreleaseooofoopatientoore
cords?oo-ooans--Patientooaccessootooopsychotherapyoonotesoomayoobeoorestricted.
Whyoodoesoocorrectooclaimooprocessingoorelyooonooaccuratelyoocompleteooencounteroofor
ms?oo-ooans--
Theyoostreamlineoopatientoobillingoobyoosummarizingootheooservicesoorenderedooforooaoogi
venoodateooofooservice.
Whenoopostingoopaymentooaccurately,oowhichooofootheoofollowingooitemsooshouldootheoobi
llingooandoocodingoospecialistooinclude?oo-ooans--Patient'sooresponsibility
Aoodependentoochildoowhoseooparentsoobothoohaveooinsuranceoocoverageoocomesootooot
heooclinic.ooTheoobillingooandoocodingoospecialistoousesootheoobirthdayooruleootooodetermin
eoowhichooinsuranceoopolicyooisooprimary.ooWhichooofootheoofollowingoodescribesootheoobir
thdayoorule?oo-ooans--
Theooparentoowhoseoobirthdateoocomesoofirstooinootheoocalendarooyear
Whichooofootheoofollowingooactionsooshouldootheoobillingooandoocodingoospecialistootakeoot
oooeffectivelyoomanageooaccountsooreceivable?oo-ooans--
Collectoocopaymentoofromootheoopatientooatootheootimeooofooservice.
Ifooaoopatientoohasooosteomyelitis,ooheoohasooproblemsoowithoowhichooofootheoofollowingoo
areas?oo-ooans--Bonesooandooboneoomarrow
Whichooofootheoofollowingooisoousedoobyooprovidersootoooremoveooerrorsoofromooclaimsoob
eforeootheyooareoosubmittedootooothird-partyoopayers?oo-ooans--Clearinghouse
Aooproviderooreceivesooaooreimbursementoofromooaoothird-
partyoopayerooaccompaniedoobyoowhichooofootheoofollowingoodocuments?oo-ooans--
Explanationooofoobenefits
Aoopatientoopresentsootoootheooprovideroowithoochestoopainooandooshortnessooofoobreath.o
oAfterooanoounexpectedooECGooresult,ootheooprovideroocallsooaoocardiologistooandoosumm
arizesootheoopatient'soosymptoms.ooWhatooportionooofooHIPAAooallowsootheooproviderootoo
ospeakootoootheoocardiologistoopriorootoooobtainingootheoopatient'sooconsent?oo-ooans--
TitleooII
Aoophysicianooisoocontractedoowithooanooinsuranceoocompanyootoooacceptootheooallowedoo
amount.ooTheooinsuranceoocompanyooallowsoo$80ooofooaoo$120oobilledooamount,ooandoo$
50ooofootheoodeductibleoohasoonotoobeenoomet.ooHowoomuchooshouldootheoophysicianoowri
teoooffootheoopatient'sooaccount?oo-ooans--$40
Whichooofootheoofollowingoosectionsooofootheoomedicaloorecordooisoousedootooodetermineoo
theoocorrectooEvaluationooandooManagementoocodeoousedooforoobillingooandoocoding?oo-
ooans--Historyooandoophysical
AoobillingooandoocodingoospecialistooisooreviewingooaooCMS-
1500ooclaimooform.ooTheooassignmentooofoobenefitsooboxoohasoobeenoocheckedooyes.ooT
heoocheckedooboxooindicatesoowhichooofootheoofollowing?oo-ooans--
Theooproviderooreceivesoopaymentoodirectlyoofromootheoopayer.
Whichooofootheoofollowingoodooophysiciansoouseootoooelectronicallyoosubmitooclaims?oo-
ooans--Clearinghouse
Whichooofootheoofollowingooshouldootheoobillingooandoocodingoospecialistooincludeooinooano
oauthorizationootoooreleaseooinformation?oo-ooans--
Theooentityootooowhomootheooinformationooisootooobeooreleased
Whichooofootheoofollowingoodescribesootheoocontentooofooaoomedicaloopracticeooagingoorep
ort?oo-ooans--Anoooverviewooofootheoopractice'soooutstandingooclaims
HIPAAootransactionoostandardsooapplyootooowhichooofootheoofollowingooentities?oo-ooans--
Healthoocareooclearinghouses
Whenooaoophysicianoodocumentsooaoopatient'sooresponseootooosymptomsooandoovariouso
obodyoosystems,ootheooresultsooareoodocumentedooasoowhichooofootheoofollowing?oo-
ooans--Reviewooofoosystems
, WhichoopartooofooMedicareoocoversooprescriptions?oo-ooans--PartooD
Whichooofootheoofollowingooindicatesooaooclaimooshouldoobeoosubmittedooonoopaperooinste
adooofooelectronically?oo-ooans--Theooclaimoorequiresooanooattachment.
Medicareooenforcesoomandatoryoosubmissionooofooelectronicooclaimsooforoomostooprovide
rs.ooWhichooofootheoofollowingooprovidersooisooallowedootooosubmitoopaperooclaimsootoooM
edicare?oo-ooans--Aooprovider'sooofficeoowithoofeweroothanoo10oofull-timeooemployees
Whichooofootheoofollowingooisootheoocorrectootermooforooanooamountoothatoohasoobeenoodet
erminedootooobeoouncollectable?oo-ooans--Badoodebt
Whichooofootheoofollowingoostatementsooisoocorrectooregardingooaoodeductible?oo-ooans--
Theoodeductibleooisootheoopatient'sooresponsibility.
Whichooofootheoofollowingoostatementsooisootrueooregardingootheooreleaseooofoopatientoore
cords?oo-ooans--Patientooaccessootooopsychotherapyoonotesoomayoobeoorestricted.
Whyoodoesoocorrectooclaimooprocessingoorelyooonooaccuratelyoocompleteooencounteroofor
ms?oo-ooans--
Theyoostreamlineoopatientoobillingoobyoosummarizingootheooservicesoorenderedooforooaoogi
venoodateooofooservice.
Whenoopostingoopaymentooaccurately,oowhichooofootheoofollowingooitemsooshouldootheoobi
llingooandoocodingoospecialistooinclude?oo-ooans--Patient'sooresponsibility
Aoodependentoochildoowhoseooparentsoobothoohaveooinsuranceoocoverageoocomesootooot
heooclinic.ooTheoobillingooandoocodingoospecialistoousesootheoobirthdayooruleootooodetermin
eoowhichooinsuranceoopolicyooisooprimary.ooWhichooofootheoofollowingoodescribesootheoobir
thdayoorule?oo-ooans--
Theooparentoowhoseoobirthdateoocomesoofirstooinootheoocalendarooyear
Whichooofootheoofollowingooactionsooshouldootheoobillingooandoocodingoospecialistootakeoot
oooeffectivelyoomanageooaccountsooreceivable?oo-ooans--
Collectoocopaymentoofromootheoopatientooatootheootimeooofooservice.
Ifooaoopatientoohasooosteomyelitis,ooheoohasooproblemsoowithoowhichooofootheoofollowingoo
areas?oo-ooans--Bonesooandooboneoomarrow
Whichooofootheoofollowingooisoousedoobyooprovidersootoooremoveooerrorsoofromooclaimsoob
eforeootheyooareoosubmittedootooothird-partyoopayers?oo-ooans--Clearinghouse
Aooproviderooreceivesooaooreimbursementoofromooaoothird-
partyoopayerooaccompaniedoobyoowhichooofootheoofollowingoodocuments?oo-ooans--
Explanationooofoobenefits
