NHA CBCS PRACTICE TESTS 2026 PRACTICE
QUESTION SET ONE
◉ Heath Maintenance Organization (HMO) Answer: Plan that allows
patients to only go to physicians, other health care professionals, or
hospitals on a list of approved providers, except in an emergency.
◉ Modifier Answer: Additional information about types of services,
and part of valid CPT or HCPCS codes.
◉ By signing block 12 of CMS-1500 form, a patient is doing what?
Answer: Authorizes the release of medical information.
◉ Claim Answer: Complete record of the services provided by the
health care professional, along with appropriate insurance
information.
◉ Where does the NPI number go on the CMS-1500 form? Answer:
17b
◉ What are two pieces of information that need to be collected from
patients? Answer: Full name and date of birth.
,◉ Deductible Answer: The amount of money a patient m just pay out
of pocket before the insurance company will start to pay for covered
benefits.
◉ Coinsurance Answer: the pre-established percentage of expenses
paid by the insurance company after the deductible has been met.
◉ Copayment Answer: A fixed dollar amount that must be paid each
time a patient visits a provider.
◉ Medicare Part A Answer: Provides hospitalization insurance to
eligible individuals.
◉ Medicare Part B Answer: Voluntary supplemental medical
insurance to help pay for physicians' and other medical
professionals' services, medical services, and medical-surgical
supplies not covered by Medicare Part A.
◉ Medicare Advantage (MA) Answer: Combined package of benefits
under Medicare Parts A and B that may offer extra coverage for
services such as vision, hearing, dental, health and wellness, or
prescription drug coverage.
◉ Medicare Part D Answer: A p.an run by private insurance
companies and other vendors approved by Medicare.
, ◉ Medigap Answer: A private health insurance that pays for most of
the charges not covered by Parts A and B.
◉ What are the three major kinds of government insurance plans?
Answer: Medicare, Medicaid, and State Children's Health Insurance
Program (SCHIP)
◉ Referral Answer: Written recommendation to a specialist.
◉ Precertification Answer: A review that looks at whether the
procedure could be performed safely but less expensively in an out
patient setting.
◉ Predetermination Answer: A written request for a verification of
benefits.
◉ Who is usually the gatekeeper? Answer: Primary care physician
◉ Preauthorization Answer: Approval from the health plan for an
inpatient hospital stay or surgery.
◉ Formulary Answer: A list of prescription drugs covered by an
insurance plan.
QUESTION SET ONE
◉ Heath Maintenance Organization (HMO) Answer: Plan that allows
patients to only go to physicians, other health care professionals, or
hospitals on a list of approved providers, except in an emergency.
◉ Modifier Answer: Additional information about types of services,
and part of valid CPT or HCPCS codes.
◉ By signing block 12 of CMS-1500 form, a patient is doing what?
Answer: Authorizes the release of medical information.
◉ Claim Answer: Complete record of the services provided by the
health care professional, along with appropriate insurance
information.
◉ Where does the NPI number go on the CMS-1500 form? Answer:
17b
◉ What are two pieces of information that need to be collected from
patients? Answer: Full name and date of birth.
,◉ Deductible Answer: The amount of money a patient m just pay out
of pocket before the insurance company will start to pay for covered
benefits.
◉ Coinsurance Answer: the pre-established percentage of expenses
paid by the insurance company after the deductible has been met.
◉ Copayment Answer: A fixed dollar amount that must be paid each
time a patient visits a provider.
◉ Medicare Part A Answer: Provides hospitalization insurance to
eligible individuals.
◉ Medicare Part B Answer: Voluntary supplemental medical
insurance to help pay for physicians' and other medical
professionals' services, medical services, and medical-surgical
supplies not covered by Medicare Part A.
◉ Medicare Advantage (MA) Answer: Combined package of benefits
under Medicare Parts A and B that may offer extra coverage for
services such as vision, hearing, dental, health and wellness, or
prescription drug coverage.
◉ Medicare Part D Answer: A p.an run by private insurance
companies and other vendors approved by Medicare.
, ◉ Medigap Answer: A private health insurance that pays for most of
the charges not covered by Parts A and B.
◉ What are the three major kinds of government insurance plans?
Answer: Medicare, Medicaid, and State Children's Health Insurance
Program (SCHIP)
◉ Referral Answer: Written recommendation to a specialist.
◉ Precertification Answer: A review that looks at whether the
procedure could be performed safely but less expensively in an out
patient setting.
◉ Predetermination Answer: A written request for a verification of
benefits.
◉ Who is usually the gatekeeper? Answer: Primary care physician
◉ Preauthorization Answer: Approval from the health plan for an
inpatient hospital stay or surgery.
◉ Formulary Answer: A list of prescription drugs covered by an
insurance plan.
