NHA CBCS CERTIFICATION QUESTIONS
WITH CORRECT ANSWERS 2025
WhichBofBtheBfollowingBisBconsideredBtheBfinalBdeterminationBofBtheBissuesBinvolvingBsettlementBofBanBins
uranceBclaim?B-BCORRECTBANSWERB-Adjudication
ABformBthatBcontainsBcharges,BDOS,BCPTBcodes,BICDBcodes,BfeesBandBcopaymentBinformationBisBcalledBwhic
hBofBtheBfollowing?B-BCORRECTBANSWERB-EncounterBform
ABpatientBcomesBtoBtheBhospitalBforBanBinpatientBprocedure.BWhichBofBtheBfollowingBhospitalBstaffBmembe
rsBisBresponsibleBforBtheBinitialBpatientBinterview,BobtainingBdemographicBandBinsuranceBinformation,BandB
documentingBtheBchiefBcomplaint?B-BCORRECTBANSWERB-AdmittingBclerk
WhichBofBtheBfollowingBprivacyBmeasuresBensuresBprotectedBhealthBinformationB(phi)?B-
BCORRECTBANSWERB-UsingBdataBencryptionBsoftwareBonBofficeBworkstations
WhichBofBtheBfollowingBplanesBdividesBtheBbodyBintoBleftBandBright?B-BCORRECTBANSWERB-Sagittal
WhichBofBtheBfollowingBprovisionsBensuresBthatBanBinsured'sBbenefitsBfromBallBinsuranceBcompaniesBdoBno
tBexceedB100%BofBallowableBmedicalBexpenses?B-BCORRECTBANSWERB-CoordinationBofBbenefits
WhichBofBtheBfollowingBactionsBshouldBbeBtakenBfirstBwhenBreviewingBaBdelinquentBclaim?B-
BCORRECTBANSWERB-VerifyBtheBageBofBtheBaccount
WhichBofBtheBfollowingBisBtheBadvantageBofBelectronicBclaimBsubmission?B-BCORRECTBANSWERB-
ClaimsBareBexpedited
WhichBofBtheBfollowingBcomponentsBofBanBexplanationBofBbenefitsBexpeditesBtheBprocessBofBaBphoneBappe
al?B-BCORRECTBANSWERB-ClaimBcontrolBnumber
TheBstandardBmedicalBabbreviationBECGBrefersBtoBaBtestBusedBtoBassessBwhichBofBtheBfollowingBbodyBsyste
ms?B-BCORRECTBANSWERB-CardiovascularBsystem
,WhichBofBtheBfollowingBactionsBbyBaBbillingBandBcodingBspecialistBwouldBbeBconsideredBfraud?B-
BCORRECTBANSWERB-BillingBforBservicesBnotBprovided
TheB><BsymbolBisBusedBtoBindicateBaBnewBandBrevisedBtestBotherBthanBwhichBofBtheBfollowing?B-
BCORRECTBANSWERB-ProcedureBdescriptors
OnBtheBCMS-1500BclaimBform,BblocksB14BthroughB33BcontainBinformationBaboutBwhichBofBtheBfollowing?B-
BCORRECTBANSWERB-TheBpatient'sBconditionBandBtheBprovider'sBinformation
WhichBofBtheBfollowingBincludesBproceduresBandBbestBpracticesBforBcorrectBcoding?B-BCORRECTBANSWERB-
CodingBComplianceBPlan
WhenBcompletingBaBCMS-
1500BpaperBclaimBform,BwhichBofBtheBfollowingBisBanBacceptableBactionBforBtheBbillingBandBcodingBspecialis
tBtoBtake?B-BCORRECTBANSWERB-UseBarialBsizeB10Bfont
ABparticipatingBblueBcross/blueBshieldB(BC/BS)BproviderBreceivesBanBexplanationBofBbenefitsBforBaBpatientBa
ccount.BTheBchargedBamountBwasB$100.BBC/BSBallowedB$80BandBappliedB$40BtoBtheBpatient'sBannualBdedu
ctible.BBC/BSBpaidBtheBbalanceBatB80%.BHowBmuchBshouldBtheBpatientBexpectBtoBpay?B-
BCORRECTBANSWERB-$48
WhichBofBtheBfollowingBindicatesBaBclaimBshouldBbeBsubmittedBonBpaperBinsteadBofBelectronically?B-
BCORRECTBANSWERB-TheBclaimBrequiresBanBattachment
AccordingBtoBHIPAABstandards,BwhichBofBtheBfollowingBidentifiesBtheBrenderingBproviderBonBtheBCMS-
1500BclaimBformBinBblockB24j?B-BCORRECTBANSWERB-NPI
WhichBofBtheBfollowingBblocksBshouldBtheBbillingBandBcodingBspecialistBcompleteBonBtheBCMS-
1500BclaimBformBformBforBprocedures,BservicesBorBsuppliesB(CPT/HCPCS)?B-BCORRECTBANSWERB-BlockB24D
WhichBofBtheBfollowingBtermsBdescribesBwhenBaBplanBpaysB70%BofBtheBallowedBamountBandBtheBpatientBp
aysB30%?B-BCORRECTBANSWERB-Coinsurance
, ABproviderBchargedB$500BtoBclaimBthatBhadBanBallowableBamountBofB$400.BInBwhichBofBtheBfollowingBcolu
mnsBshouldBtheBbillingBandBcodingBspecialistBapplyBtheBnon-allowedBcharge?B-BCORRECTBANSWERB-
AdjustmentBcolumnBofBtheBcredits
WhichBofBtheBfollowingBisBaBHIPAABcomplianceBguidelineBaffectingBelectronicBhealthBrecords?B-
BCORRECTBANSWERB-
TheBelectronicBtransmissionBandBcodeBsetBstandardsBrequireBeveryBproviderBtoBuseBtheBhealthcareBtransac
tionsB,codeBsetsBandBidentifiers
Patient:BJaneBAustin;BSocialBSecurityB#B555-22-1111;BMedicareBID:B555-33-
2222A;BDOB:B05/22/1945.BClaimBinformationBentered:BAustin,BJane;BSocialBSecurityB#.:B555-22-
1111;BMedicareBIDBNo.:B555-33-
2222A;BDOB:B052245.BWhichBofBtheBfollowingBisBaBreasonBthisBclaimBwasBrejected?B-BCORRECTBANSWERB-
TheBDOBBisBenteredBincorrectly
WhyBdoesBcorrectBclaimBprocessingBrelyBonBaccuratelyBcompletedBencounterBforms?B-
BCORRECTBANSWERB-
TheyBstreamlineBpatientBbillingBbyBsummarizingBtheBservicesBrenderedBforBaBgivenBdateBofBservice
ABpatient'sBhealthBplanBisBreferredBtoBasBtheB"payerBofBlastBresort."BTheBpatientBisBcoveredBbyBwhichBofBtheB
followingBhealthBplans?B-BCORRECTBANSWERB-Medicaid
WhichBofBtheBfollowingBcolorBformatsBisBacceptableBonBtheBCMS-1500BclaimBform?B-BCORRECTBANSWERB-
Red
WhichBofBtheBfollowingBisBanBexampleBofBaBviolationBofBanBadultBpatient'sBconfidentiality?B-
BCORRECTBANSWERB-PatientBinformationBwasBdisclosedBtoBtheBpatient'sBparentsBwithoutBconsent.
InBtheBanesthesiaBsectionBofBtheBCPTBmanual,BwhichBofBtheBfollowingBareBconsideredBqualifyingBcircumsta
nces?B-BCORRECTBANSWERB-Add-onBcodes
AmbulatoryBsurgeryBcenters,BhomeBhealthBcare,BandBhospiceBorganizationsBuseBtheB-BCORRECTBANSWERB-
UB-04BclaimBform
WITH CORRECT ANSWERS 2025
WhichBofBtheBfollowingBisBconsideredBtheBfinalBdeterminationBofBtheBissuesBinvolvingBsettlementBofBanBins
uranceBclaim?B-BCORRECTBANSWERB-Adjudication
ABformBthatBcontainsBcharges,BDOS,BCPTBcodes,BICDBcodes,BfeesBandBcopaymentBinformationBisBcalledBwhic
hBofBtheBfollowing?B-BCORRECTBANSWERB-EncounterBform
ABpatientBcomesBtoBtheBhospitalBforBanBinpatientBprocedure.BWhichBofBtheBfollowingBhospitalBstaffBmembe
rsBisBresponsibleBforBtheBinitialBpatientBinterview,BobtainingBdemographicBandBinsuranceBinformation,BandB
documentingBtheBchiefBcomplaint?B-BCORRECTBANSWERB-AdmittingBclerk
WhichBofBtheBfollowingBprivacyBmeasuresBensuresBprotectedBhealthBinformationB(phi)?B-
BCORRECTBANSWERB-UsingBdataBencryptionBsoftwareBonBofficeBworkstations
WhichBofBtheBfollowingBplanesBdividesBtheBbodyBintoBleftBandBright?B-BCORRECTBANSWERB-Sagittal
WhichBofBtheBfollowingBprovisionsBensuresBthatBanBinsured'sBbenefitsBfromBallBinsuranceBcompaniesBdoBno
tBexceedB100%BofBallowableBmedicalBexpenses?B-BCORRECTBANSWERB-CoordinationBofBbenefits
WhichBofBtheBfollowingBactionsBshouldBbeBtakenBfirstBwhenBreviewingBaBdelinquentBclaim?B-
BCORRECTBANSWERB-VerifyBtheBageBofBtheBaccount
WhichBofBtheBfollowingBisBtheBadvantageBofBelectronicBclaimBsubmission?B-BCORRECTBANSWERB-
ClaimsBareBexpedited
WhichBofBtheBfollowingBcomponentsBofBanBexplanationBofBbenefitsBexpeditesBtheBprocessBofBaBphoneBappe
al?B-BCORRECTBANSWERB-ClaimBcontrolBnumber
TheBstandardBmedicalBabbreviationBECGBrefersBtoBaBtestBusedBtoBassessBwhichBofBtheBfollowingBbodyBsyste
ms?B-BCORRECTBANSWERB-CardiovascularBsystem
,WhichBofBtheBfollowingBactionsBbyBaBbillingBandBcodingBspecialistBwouldBbeBconsideredBfraud?B-
BCORRECTBANSWERB-BillingBforBservicesBnotBprovided
TheB><BsymbolBisBusedBtoBindicateBaBnewBandBrevisedBtestBotherBthanBwhichBofBtheBfollowing?B-
BCORRECTBANSWERB-ProcedureBdescriptors
OnBtheBCMS-1500BclaimBform,BblocksB14BthroughB33BcontainBinformationBaboutBwhichBofBtheBfollowing?B-
BCORRECTBANSWERB-TheBpatient'sBconditionBandBtheBprovider'sBinformation
WhichBofBtheBfollowingBincludesBproceduresBandBbestBpracticesBforBcorrectBcoding?B-BCORRECTBANSWERB-
CodingBComplianceBPlan
WhenBcompletingBaBCMS-
1500BpaperBclaimBform,BwhichBofBtheBfollowingBisBanBacceptableBactionBforBtheBbillingBandBcodingBspecialis
tBtoBtake?B-BCORRECTBANSWERB-UseBarialBsizeB10Bfont
ABparticipatingBblueBcross/blueBshieldB(BC/BS)BproviderBreceivesBanBexplanationBofBbenefitsBforBaBpatientBa
ccount.BTheBchargedBamountBwasB$100.BBC/BSBallowedB$80BandBappliedB$40BtoBtheBpatient'sBannualBdedu
ctible.BBC/BSBpaidBtheBbalanceBatB80%.BHowBmuchBshouldBtheBpatientBexpectBtoBpay?B-
BCORRECTBANSWERB-$48
WhichBofBtheBfollowingBindicatesBaBclaimBshouldBbeBsubmittedBonBpaperBinsteadBofBelectronically?B-
BCORRECTBANSWERB-TheBclaimBrequiresBanBattachment
AccordingBtoBHIPAABstandards,BwhichBofBtheBfollowingBidentifiesBtheBrenderingBproviderBonBtheBCMS-
1500BclaimBformBinBblockB24j?B-BCORRECTBANSWERB-NPI
WhichBofBtheBfollowingBblocksBshouldBtheBbillingBandBcodingBspecialistBcompleteBonBtheBCMS-
1500BclaimBformBformBforBprocedures,BservicesBorBsuppliesB(CPT/HCPCS)?B-BCORRECTBANSWERB-BlockB24D
WhichBofBtheBfollowingBtermsBdescribesBwhenBaBplanBpaysB70%BofBtheBallowedBamountBandBtheBpatientBp
aysB30%?B-BCORRECTBANSWERB-Coinsurance
, ABproviderBchargedB$500BtoBclaimBthatBhadBanBallowableBamountBofB$400.BInBwhichBofBtheBfollowingBcolu
mnsBshouldBtheBbillingBandBcodingBspecialistBapplyBtheBnon-allowedBcharge?B-BCORRECTBANSWERB-
AdjustmentBcolumnBofBtheBcredits
WhichBofBtheBfollowingBisBaBHIPAABcomplianceBguidelineBaffectingBelectronicBhealthBrecords?B-
BCORRECTBANSWERB-
TheBelectronicBtransmissionBandBcodeBsetBstandardsBrequireBeveryBproviderBtoBuseBtheBhealthcareBtransac
tionsB,codeBsetsBandBidentifiers
Patient:BJaneBAustin;BSocialBSecurityB#B555-22-1111;BMedicareBID:B555-33-
2222A;BDOB:B05/22/1945.BClaimBinformationBentered:BAustin,BJane;BSocialBSecurityB#.:B555-22-
1111;BMedicareBIDBNo.:B555-33-
2222A;BDOB:B052245.BWhichBofBtheBfollowingBisBaBreasonBthisBclaimBwasBrejected?B-BCORRECTBANSWERB-
TheBDOBBisBenteredBincorrectly
WhyBdoesBcorrectBclaimBprocessingBrelyBonBaccuratelyBcompletedBencounterBforms?B-
BCORRECTBANSWERB-
TheyBstreamlineBpatientBbillingBbyBsummarizingBtheBservicesBrenderedBforBaBgivenBdateBofBservice
ABpatient'sBhealthBplanBisBreferredBtoBasBtheB"payerBofBlastBresort."BTheBpatientBisBcoveredBbyBwhichBofBtheB
followingBhealthBplans?B-BCORRECTBANSWERB-Medicaid
WhichBofBtheBfollowingBcolorBformatsBisBacceptableBonBtheBCMS-1500BclaimBform?B-BCORRECTBANSWERB-
Red
WhichBofBtheBfollowingBisBanBexampleBofBaBviolationBofBanBadultBpatient'sBconfidentiality?B-
BCORRECTBANSWERB-PatientBinformationBwasBdisclosedBtoBtheBpatient'sBparentsBwithoutBconsent.
InBtheBanesthesiaBsectionBofBtheBCPTBmanual,BwhichBofBtheBfollowingBareBconsideredBqualifyingBcircumsta
nces?B-BCORRECTBANSWERB-Add-onBcodes
AmbulatoryBsurgeryBcenters,BhomeBhealthBcare,BandBhospiceBorganizationsBuseBtheB-BCORRECTBANSWERB-
UB-04BclaimBform
