NCCT Medical Office Billing and Coding
2025/2026 Exam Questions Marking
Scheme New Update | A+ Rated
The main purpose for verifying a patient's insurance coverage at every visit
is to - 🧠 ANSWER ✔✔prevent claim rejection due to ineligibility or non-
active status.
Rationale
This also ensures the correct insurer is billed and facilitates timely
reimbursement for the provider. The medical assistant should scan into the
EHR or make a copy of both sides of the patient's current insurance card.
Which of the following must be filled out by the patient in order to forward
payment to the physician's office? - 🧠 ANSWER ✔✔assignment of benefits
Rationale
1
COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
,If a patient's health insurance contract allows for assignment of benefits,
the patient first fills out a form giving permission that any allowable benefit
payment be sent to the medical provider. Without the AOB, any
reimbursement would then be issued to the patient, then they would have
to be billed by the medical office for payment. The AOB process cuts out
the extra step.
Which of the following documents does the provider or facility need to
submit in order to receive reimbursement from an insurance company? - 🧠
ANSWER ✔✔CMS-1500
Rationale
The CMS-1500 is the form to be used to enable the provider or medical
facility to receive reimbursement directly from a patient's insurance
company.
Which of the following forms is used by the medical office to ensure that
insurance payments are made directly to the physician? - 🧠 ANSWER
✔✔assignment of benefits
Rationale
2
COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
,If a patient's health insurance contract allows for assignment of benefits,
the patient first fills out a form giving permission that any allowable benefit
payment be sent to the medical provider. The CMS-1500 is the basic form
for the Medicare and Medicaid programs for claims from physicians and
suppliers. A UB-04 form is the electronic format of the CMS-1450 claim
form. A consent form does not allow for payments from an insurance
carrier, only for the patient to consent to accept medical treatment.
Which of the following is the most likely cause of the deposits not agreeing
with the credits on the day sheet or the patient ledgers? - 🧠 ANSWER
✔✔Payment is misplaced.
Rationale
The first step of reconciliation is to first determine if a payment is
misplaced. Then issues of duplication or misplaced monies can be
addressed. Transactions involving a possible bank error would be the last
thing to check before checking the medical office records.
3
COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
, When posting an insurance payment via an EOB, the amount that is
considered contractual is the - 🧠 ANSWER ✔✔Insurance allowed amount.
Rationale
An Explanation of Benefits (EOB) is a document from the insurance
company to the patient that includes detailed information regarding a claim
that was paid to the health care provider. Once a provider accepts the
allowed charges (fee schedule) for a particular procedure, it is accepting
assignment. The provider agrees to accept the contractual amount
(insurance adjustment) as payment in full from the insurance company. An
adjustment is basically a billing discount in accordance with a contract
between the health care provider and insurance company. Participating
(PAR) and Non-Participating (NON-PAR) providers choose whether to
participate in the Medicare program and either accept or not accept
assignment on Medicare claims.
A list of all account balances and the amounts owed to the medical practice
at the end of the day is called an - 🧠 ANSWER ✔✔accounts receivable
report.
Rationale
4
COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
2025/2026 Exam Questions Marking
Scheme New Update | A+ Rated
The main purpose for verifying a patient's insurance coverage at every visit
is to - 🧠 ANSWER ✔✔prevent claim rejection due to ineligibility or non-
active status.
Rationale
This also ensures the correct insurer is billed and facilitates timely
reimbursement for the provider. The medical assistant should scan into the
EHR or make a copy of both sides of the patient's current insurance card.
Which of the following must be filled out by the patient in order to forward
payment to the physician's office? - 🧠 ANSWER ✔✔assignment of benefits
Rationale
1
COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
,If a patient's health insurance contract allows for assignment of benefits,
the patient first fills out a form giving permission that any allowable benefit
payment be sent to the medical provider. Without the AOB, any
reimbursement would then be issued to the patient, then they would have
to be billed by the medical office for payment. The AOB process cuts out
the extra step.
Which of the following documents does the provider or facility need to
submit in order to receive reimbursement from an insurance company? - 🧠
ANSWER ✔✔CMS-1500
Rationale
The CMS-1500 is the form to be used to enable the provider or medical
facility to receive reimbursement directly from a patient's insurance
company.
Which of the following forms is used by the medical office to ensure that
insurance payments are made directly to the physician? - 🧠 ANSWER
✔✔assignment of benefits
Rationale
2
COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
,If a patient's health insurance contract allows for assignment of benefits,
the patient first fills out a form giving permission that any allowable benefit
payment be sent to the medical provider. The CMS-1500 is the basic form
for the Medicare and Medicaid programs for claims from physicians and
suppliers. A UB-04 form is the electronic format of the CMS-1450 claim
form. A consent form does not allow for payments from an insurance
carrier, only for the patient to consent to accept medical treatment.
Which of the following is the most likely cause of the deposits not agreeing
with the credits on the day sheet or the patient ledgers? - 🧠 ANSWER
✔✔Payment is misplaced.
Rationale
The first step of reconciliation is to first determine if a payment is
misplaced. Then issues of duplication or misplaced monies can be
addressed. Transactions involving a possible bank error would be the last
thing to check before checking the medical office records.
3
COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
, When posting an insurance payment via an EOB, the amount that is
considered contractual is the - 🧠 ANSWER ✔✔Insurance allowed amount.
Rationale
An Explanation of Benefits (EOB) is a document from the insurance
company to the patient that includes detailed information regarding a claim
that was paid to the health care provider. Once a provider accepts the
allowed charges (fee schedule) for a particular procedure, it is accepting
assignment. The provider agrees to accept the contractual amount
(insurance adjustment) as payment in full from the insurance company. An
adjustment is basically a billing discount in accordance with a contract
between the health care provider and insurance company. Participating
(PAR) and Non-Participating (NON-PAR) providers choose whether to
participate in the Medicare program and either accept or not accept
assignment on Medicare claims.
A list of all account balances and the amounts owed to the medical practice
at the end of the day is called an - 🧠 ANSWER ✔✔accounts receivable
report.
Rationale
4
COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
