CBCS
practice
test
Medicaid - ✔✔- ACTUAL ANSWER- A patient's health plan is referred to as the
payer of last resort. The patient is covered by which of the following health
plans?
Medicaid
CHAMPA
Medicare
TRICARE
Adjustment column of the credits - ✔✔- ACTUAL ANSWER- A provider charged
$500 to a claim that had an allowable amount of $400. In which of the following
columns should the CBCS apply the non allowed charge?
-Reference column (For notations)
,-Description column
-Payment column
-Adjustment column of the credits
The deductible is the patient's responsibility - ✔✔- ACTUAL ANSWER- Which of
the following statements is correct regarding a deductible?
-Coinsurance is a type of deductible
-The physician should write off the deductible
-The insurance company pays for the deductible
-The deductible is the patient's responsibility
red - ✔✔- ACTUAL ANSWER- Which of the following color formats allows
optical scanning of the CMS-1500 claim form?
-Red
-Blue
-Green
-black
UB-04 - ✔✔- ACTUAL ANSWER- Ambulatory surgery centers, home health and
hospice organizations use the ______.
-CMS-1500 claim form
-UB-04 claim form
-Advance Beneficiary notice
-First report of injury form
The number is needed to identify the provider - ✔✔- ACTUAL ANSWER- Claims
that are submitted without an NPI number will delay payment to the provider
because ______.
-The number is the patient' id number
-The number is needed to identify the provider
-Is is used as a claim number
-It is used as a pre authorization number
coinsurance - ✔✔- ACTUAL ANSWER- Which of the following terms describes
when a plan pays 70% of the allowed amount and the patient pays 30%?
-Coinsurance
-Deductible
,-Premium
-copayment
the claim requires an attachment - ✔✔- ACTUAL ANSWER- Which of the
following indicates a claim should be submitted on paper instead of
electronically?
-The software claims review process indicates the claim is not complete
-The claim needs authorization
-The claim requires an attachment
-The practice management software is non functional.
provider - ✔✔- ACTUAL ANSWER- On a remittance advice form, which of the
following is responsible for writing off the difference between the amount billed
and the amount allowed by the agreement?
-Provider
-Insurance company
-Patient
-Third party payer
$40 - ✔✔- ACTUAL ANSWER- A physician is contracted with an insurance
company to accept the amount. The insurance company allows $80 of a $120
billed amount, and $50 of the deductible has not been met. How much should the
physician write off the patient's account?
-$40
-$15
-$0
-$50
Guidelines prior to each section - ✔✔- ACTUAL ANSWER- The unlisted codes
can be found in which of the following locations in the CPT manual?
-Appendix L
-Guidelines prior to each section
-End of each body system
-Table of contents
Block 24D
-Block 12 (patient's authorization block
, -Block 2 ( patient's name)
-Block 24J ( for the rendering provider) - ✔✔- ACTUAL ANSWER- Which of the
following blocks should the billing and coding specialist complete the CMS 1500
claims form for procedure, services or supplies?
-Block 12
-Block 2
-Block 24D
-Block 24J
Block 12
- Block 13 patient authorization for benefits required for third party payer
- Block 27 accepting assignment of benefits
- Block 31 (treating physician) - ✔✔- ACTUAL ANSWER- Which of the following
blocks requires the patient's authorization to release medical information to
process a claim?
Block 12
Block 13
Block 27
Block 31
Internal monitoring and auditing - ✔✔- ACTUAL ANSWER- Which of the
following steps would be part of a physician's practice compliance program?
-HIPAA compliance audit
-Physician recruitment
-Internal monitoring and auditing
-Notice of privacy practice
Communicating with the front desk staff during a team meeting about missing
information in patient files - ✔✔- ACTUAL ANSWER- Behavior plays an
important part of being a team player in a medical practice. Which of the
following is an appropriate action for the CBCS to take?
-Reprimanding another staff member during a team meeting for displaying a bad
attitude toward a patient
-Looking in the medical record of a friend who receives services at the office
-Communicating with the front desk staff during a team meeting about missing
information in patient files
-Questioning the nurse about the provider documentation in the medical record
practice
test
Medicaid - ✔✔- ACTUAL ANSWER- A patient's health plan is referred to as the
payer of last resort. The patient is covered by which of the following health
plans?
Medicaid
CHAMPA
Medicare
TRICARE
Adjustment column of the credits - ✔✔- ACTUAL ANSWER- A provider charged
$500 to a claim that had an allowable amount of $400. In which of the following
columns should the CBCS apply the non allowed charge?
-Reference column (For notations)
,-Description column
-Payment column
-Adjustment column of the credits
The deductible is the patient's responsibility - ✔✔- ACTUAL ANSWER- Which of
the following statements is correct regarding a deductible?
-Coinsurance is a type of deductible
-The physician should write off the deductible
-The insurance company pays for the deductible
-The deductible is the patient's responsibility
red - ✔✔- ACTUAL ANSWER- Which of the following color formats allows
optical scanning of the CMS-1500 claim form?
-Red
-Blue
-Green
-black
UB-04 - ✔✔- ACTUAL ANSWER- Ambulatory surgery centers, home health and
hospice organizations use the ______.
-CMS-1500 claim form
-UB-04 claim form
-Advance Beneficiary notice
-First report of injury form
The number is needed to identify the provider - ✔✔- ACTUAL ANSWER- Claims
that are submitted without an NPI number will delay payment to the provider
because ______.
-The number is the patient' id number
-The number is needed to identify the provider
-Is is used as a claim number
-It is used as a pre authorization number
coinsurance - ✔✔- ACTUAL ANSWER- Which of the following terms describes
when a plan pays 70% of the allowed amount and the patient pays 30%?
-Coinsurance
-Deductible
,-Premium
-copayment
the claim requires an attachment - ✔✔- ACTUAL ANSWER- Which of the
following indicates a claim should be submitted on paper instead of
electronically?
-The software claims review process indicates the claim is not complete
-The claim needs authorization
-The claim requires an attachment
-The practice management software is non functional.
provider - ✔✔- ACTUAL ANSWER- On a remittance advice form, which of the
following is responsible for writing off the difference between the amount billed
and the amount allowed by the agreement?
-Provider
-Insurance company
-Patient
-Third party payer
$40 - ✔✔- ACTUAL ANSWER- A physician is contracted with an insurance
company to accept the amount. The insurance company allows $80 of a $120
billed amount, and $50 of the deductible has not been met. How much should the
physician write off the patient's account?
-$40
-$15
-$0
-$50
Guidelines prior to each section - ✔✔- ACTUAL ANSWER- The unlisted codes
can be found in which of the following locations in the CPT manual?
-Appendix L
-Guidelines prior to each section
-End of each body system
-Table of contents
Block 24D
-Block 12 (patient's authorization block
, -Block 2 ( patient's name)
-Block 24J ( for the rendering provider) - ✔✔- ACTUAL ANSWER- Which of the
following blocks should the billing and coding specialist complete the CMS 1500
claims form for procedure, services or supplies?
-Block 12
-Block 2
-Block 24D
-Block 24J
Block 12
- Block 13 patient authorization for benefits required for third party payer
- Block 27 accepting assignment of benefits
- Block 31 (treating physician) - ✔✔- ACTUAL ANSWER- Which of the following
blocks requires the patient's authorization to release medical information to
process a claim?
Block 12
Block 13
Block 27
Block 31
Internal monitoring and auditing - ✔✔- ACTUAL ANSWER- Which of the
following steps would be part of a physician's practice compliance program?
-HIPAA compliance audit
-Physician recruitment
-Internal monitoring and auditing
-Notice of privacy practice
Communicating with the front desk staff during a team meeting about missing
information in patient files - ✔✔- ACTUAL ANSWER- Behavior plays an
important part of being a team player in a medical practice. Which of the
following is an appropriate action for the CBCS to take?
-Reprimanding another staff member during a team meeting for displaying a bad
attitude toward a patient
-Looking in the medical record of a friend who receives services at the office
-Communicating with the front desk staff during a team meeting about missing
information in patient files
-Questioning the nurse about the provider documentation in the medical record
