AAPC CPB - CHAPTER 2: QUESTIONS
& ANSWERS 2025
Why must a provider obtain an NPI number?
I. To submit claims
II. To prove that he is licensed
III. To be HIPAA compliant
IV. To guarantee payment by a health plan
a. I, II, III
b. II, III, IV
c. I, II, III, IV
d. I, III - CORRECT ANSWERS ✔✔d. I, III
A patient has receipts for her dental cleaning, vision exam, and contact
lenses. Her employer has set up special accounts for each employee,
there is no limit to the amount the employer can contribute and the
balances roll over from year to year. What type of account is this?
a. Flexible Spending Account (FSA)
b. Health Savings Account (HSA)
c. Health Insurance Account (HIA)
d. Traditional Healthcare Reimbursement Arrangement (HRA) -
CORRECT ANSWERS ✔✔d. Traditional Healthcare Reimbursement
Arrangement (HRA)
,AAPC CPB - CHAPTER 2: QUESTIONS
& ANSWERS 2025
A patient presents to be seen in the office. He does not pay at the time
the services are rendered as the provider is his primary care provider,
or gatekeeper. The large group practice has 800 covered members
under this plan as is paid on a monthly basis with a set amount that is
based on the number of members covered and their ages. What type of
plan is this?
a. PPO
b. Capitation
c. Fee-for-service
d. Indemnity - CORRECT ANSWERS ✔✔b. Capitation
(Capitation payments are used by managed care organizations (MCOs)
to control healthcare costs by putting the physicians at financial risk for
services provided to patients. Payments are based on a per-person rate,
rather than a fee-for-service rate.)
A family practitioner sees a Medicare patient and bills a 99213. This
provider has opted-out of Medicare. His fee for the service is $125.00.
Medicare's approved amount is $73.08, and the patient has met $0 of
his deductible. What can the provider bill the patient?
a. $125.00
b. $73.08
, AAPC CPB - CHAPTER 2: QUESTIONS
& ANSWERS 2025
c. $14.62
d. $58.46 - CORRECT ANSWERS ✔✔a. $125.00
(Providers that opt-out of Medicare are not limited to any specific
charge limit on their patients. The patient is responsible for payment in
full for services as Medicare will not pay any amount to either the
patient or provider in this situation.)
What are the options for a provider with regards to participation with
Medicare?
a. It is mandatory for every provider to participate in Medicare
b. Providers may participate, may choose not to participate, or may
opt-out of Medicare
c. Providers are automatically opted-out
d. Only participating providers must file claims - CORRECT ANSWERS
✔✔b. Providers may participate, may choose not to participate, or
may opt-out of Medicare
Which insurance is a healthcare benefit program for military personnel
in all seven uniformed branches?
a. Medicare
b. Medicaid
& ANSWERS 2025
Why must a provider obtain an NPI number?
I. To submit claims
II. To prove that he is licensed
III. To be HIPAA compliant
IV. To guarantee payment by a health plan
a. I, II, III
b. II, III, IV
c. I, II, III, IV
d. I, III - CORRECT ANSWERS ✔✔d. I, III
A patient has receipts for her dental cleaning, vision exam, and contact
lenses. Her employer has set up special accounts for each employee,
there is no limit to the amount the employer can contribute and the
balances roll over from year to year. What type of account is this?
a. Flexible Spending Account (FSA)
b. Health Savings Account (HSA)
c. Health Insurance Account (HIA)
d. Traditional Healthcare Reimbursement Arrangement (HRA) -
CORRECT ANSWERS ✔✔d. Traditional Healthcare Reimbursement
Arrangement (HRA)
,AAPC CPB - CHAPTER 2: QUESTIONS
& ANSWERS 2025
A patient presents to be seen in the office. He does not pay at the time
the services are rendered as the provider is his primary care provider,
or gatekeeper. The large group practice has 800 covered members
under this plan as is paid on a monthly basis with a set amount that is
based on the number of members covered and their ages. What type of
plan is this?
a. PPO
b. Capitation
c. Fee-for-service
d. Indemnity - CORRECT ANSWERS ✔✔b. Capitation
(Capitation payments are used by managed care organizations (MCOs)
to control healthcare costs by putting the physicians at financial risk for
services provided to patients. Payments are based on a per-person rate,
rather than a fee-for-service rate.)
A family practitioner sees a Medicare patient and bills a 99213. This
provider has opted-out of Medicare. His fee for the service is $125.00.
Medicare's approved amount is $73.08, and the patient has met $0 of
his deductible. What can the provider bill the patient?
a. $125.00
b. $73.08
, AAPC CPB - CHAPTER 2: QUESTIONS
& ANSWERS 2025
c. $14.62
d. $58.46 - CORRECT ANSWERS ✔✔a. $125.00
(Providers that opt-out of Medicare are not limited to any specific
charge limit on their patients. The patient is responsible for payment in
full for services as Medicare will not pay any amount to either the
patient or provider in this situation.)
What are the options for a provider with regards to participation with
Medicare?
a. It is mandatory for every provider to participate in Medicare
b. Providers may participate, may choose not to participate, or may
opt-out of Medicare
c. Providers are automatically opted-out
d. Only participating providers must file claims - CORRECT ANSWERS
✔✔b. Providers may participate, may choose not to participate, or
may opt-out of Medicare
Which insurance is a healthcare benefit program for military personnel
in all seven uniformed branches?
a. Medicare
b. Medicaid
