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NHA CBCS EXAM (Latest ): Most
Comprehensive Qs & Ans - to Pass the Exam
What actions should be taken when a claim is billed for a level four office visit and
paid at a level three? - ..(ANSWER)...Submit an appeal with documentation
The standard medical abbreviation "ECG" refers to a test used to assess which of
the body systems? - ..(ANSWER)...cardiovascular system- test checks electricity of
heart
According to HIPAA standards, what identifies the rendering provider on the CMS-
1500 claim form in Block 24J? - ..(ANSWER)...NPI
On the CMS-1500 claim form, blocks 14 through 33 contain information about? -
..(ANSWER)...The patient's condition and the provider's information
Which block should the BCS complete on the CMS-1500 form for procedures,
services, or supplies? - ..(ANSWER)...24D
Which term describes when a plan pays 70% of the allowed and the patient pays
30%? - ..(ANSWER)...Coinsurance is a percentage of the cost for covered services
that is approved by the insurance company
A provider charges $500 to a claim that had an allowable amount of $400. What
should happen to the non-allowed charge? - ..(ANSWER)...Write Off or
adjustment
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Patient: Justin Austin; Social Security NO.: 555-22-1111; Medicare ID NO.: 555-33-
2222A; DOB: 05/22/1945. Claim information entered: Austin, Jane; Social Security
No.: 555-22-111; Medicare ID No.: 555-33-2222A; DOB: 052245. What is a reason
the claim was rejected? - ..(ANSWER)...The DOB is entered incorrectly - the format
is two digits for the month and four digits for the year.
A patient's health plan is referred to as the "payer of last resort." The patient is
covered by which health plan? - ..(ANSWER)...Medicaid
The physician bills $500 to a patient. After submitting the claim to the insurance
company, the claim is sent back with no payment. The patient still owes $500 for
the year. This amount is called what? - ..(ANSWER)...Deductible
Ambulatory surgery centers, home health care, and hospice organizations use
what form? - ..(ANSWER)...UB-04 Form
A physician ordered a comprehensive metabolic panel for a 70-year-old patient
who has Medicare as her primary insurance. Which form is required so the
patient knows she may be responsible for payment? - ..(ANSWER)...Advanced
Beneficiary Notice is a form that is required for Medicare recipients
Which of the following should the BCS complete to be reimbursed for the
provider's services? - ..(ANSWER)...CMS-1500 claim form
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What is the maximum number of diagnoses that can be reported on the CMS-
1500 claim form before a further claim is required? - ..(ANSWER)...12
Describe a delinquent claim? - ..(ANSWER)...It is considered delinquent when it is
overdue for payment, 120 days or older
What are considered proper supportive documentation for reporting CPT and ICD
codes for surgical procedures? - ..(ANSWER)...Operative reports are required to
support surgical procedures
When submitting a clean claim with a diagnosis of kidney stones, which of the
following procedure names is correct? - ..(ANSWER)...Nephrolithiasis The
destruction of kidney stones
The BCS should first divide the e/m code by which of the following? -
..(ANSWER)...Place of service which narrows down the specific code as one of the
three deciding factors
Appeal the decision with a provider's report - ..(ANSWER)...Which of the following
actions should be taken if an insurance company denies a service as not medically
necessary?
Which departments should a patient be seen for psoriasis? And what body system
is involved? - ..(ANSWER)...Dermatology, related to the integumentary system
which includes hair, skin, and nails
NHA CBCS EXAM (Latest ): Most
Comprehensive Qs & Ans - to Pass the Exam
What actions should be taken when a claim is billed for a level four office visit and
paid at a level three? - ..(ANSWER)...Submit an appeal with documentation
The standard medical abbreviation "ECG" refers to a test used to assess which of
the body systems? - ..(ANSWER)...cardiovascular system- test checks electricity of
heart
According to HIPAA standards, what identifies the rendering provider on the CMS-
1500 claim form in Block 24J? - ..(ANSWER)...NPI
On the CMS-1500 claim form, blocks 14 through 33 contain information about? -
..(ANSWER)...The patient's condition and the provider's information
Which block should the BCS complete on the CMS-1500 form for procedures,
services, or supplies? - ..(ANSWER)...24D
Which term describes when a plan pays 70% of the allowed and the patient pays
30%? - ..(ANSWER)...Coinsurance is a percentage of the cost for covered services
that is approved by the insurance company
A provider charges $500 to a claim that had an allowable amount of $400. What
should happen to the non-allowed charge? - ..(ANSWER)...Write Off or
adjustment
,2|Page
Patient: Justin Austin; Social Security NO.: 555-22-1111; Medicare ID NO.: 555-33-
2222A; DOB: 05/22/1945. Claim information entered: Austin, Jane; Social Security
No.: 555-22-111; Medicare ID No.: 555-33-2222A; DOB: 052245. What is a reason
the claim was rejected? - ..(ANSWER)...The DOB is entered incorrectly - the format
is two digits for the month and four digits for the year.
A patient's health plan is referred to as the "payer of last resort." The patient is
covered by which health plan? - ..(ANSWER)...Medicaid
The physician bills $500 to a patient. After submitting the claim to the insurance
company, the claim is sent back with no payment. The patient still owes $500 for
the year. This amount is called what? - ..(ANSWER)...Deductible
Ambulatory surgery centers, home health care, and hospice organizations use
what form? - ..(ANSWER)...UB-04 Form
A physician ordered a comprehensive metabolic panel for a 70-year-old patient
who has Medicare as her primary insurance. Which form is required so the
patient knows she may be responsible for payment? - ..(ANSWER)...Advanced
Beneficiary Notice is a form that is required for Medicare recipients
Which of the following should the BCS complete to be reimbursed for the
provider's services? - ..(ANSWER)...CMS-1500 claim form
, 3|Page
What is the maximum number of diagnoses that can be reported on the CMS-
1500 claim form before a further claim is required? - ..(ANSWER)...12
Describe a delinquent claim? - ..(ANSWER)...It is considered delinquent when it is
overdue for payment, 120 days or older
What are considered proper supportive documentation for reporting CPT and ICD
codes for surgical procedures? - ..(ANSWER)...Operative reports are required to
support surgical procedures
When submitting a clean claim with a diagnosis of kidney stones, which of the
following procedure names is correct? - ..(ANSWER)...Nephrolithiasis The
destruction of kidney stones
The BCS should first divide the e/m code by which of the following? -
..(ANSWER)...Place of service which narrows down the specific code as one of the
three deciding factors
Appeal the decision with a provider's report - ..(ANSWER)...Which of the following
actions should be taken if an insurance company denies a service as not medically
necessary?
Which departments should a patient be seen for psoriasis? And what body system
is involved? - ..(ANSWER)...Dermatology, related to the integumentary system
which includes hair, skin, and nails
