BMC ANSWERS 2026 PROBLEM SOLVING
WORKBOOK SOLVED QUESTIONS
COMPILATION
◉ 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.
Answer: Communicating with the front desk staff during a team
meeting about missing information in patient files
◉ Which of the following acts applies to the administrative
simplification guideline?
-HIPAA
-Deficit reduction act of 2005
-The patient protection and affordable care act 2009
,-National correct coding initiative of 1995.
Answer: HIPAA
◉ Which of the following is an example of a violation of an adult
patient's confidentiality?
-While reviewing a claim, the CBCS reads the diagnosis before
realizing that the patient is a neighbor
-A CBCS queries the physician about a diagnosis in a patient's
medical record
-The physician uses his home phone to discuss patient care with the
nursing staff
-Patient information was disclosed to the patient's parents without
consent.
Answer: Patient information was disclosed to the patient's parents
without consent
◉ Which of the following is the purpose of running an aging report
each month?
-If indicates the balances the patients owe the provider
-It indicates which patients have upcoming or missed appointment
-It indicates which claims are outstanding
-It indicates what the insurance company has paid for the provider's
services to a patient..
Answer: It indicates which claims are outstanding
,◉ Which of the following describes the status of a claim that does
not include the required preauthorization for a service?
-Delinquent (overdue)
-Denied
-Suspended
-Adjudicated (claim still being processed).
Answer: Denied
-Delinquent (overdue)
-Adjudicated (claim still being processed)
◉ Which of the following actions should the CBCS take to prevent
fraud and abuse in the medical office?
-Serviced procedure preauthorization
-Internal monitoring and auditing
-Utilization review
-Correct coding initiative.
Answer: Internal monitoring and auditing
◉ In an outpatient setting, which of the following forms is used as a
financial report of all services provided to patients?
-Encounter form
, -Patient account record
-CMS-1500 claim form
-Accounts receivable journal.
Answer: Patient account record (patient ledger, all transactions
between patient and the practice)
-Accounts receivable journal (Day sheet = chronological summary of
all transaction on a specific day)
◉ Patient charges that have not been paid will appear in which of
the following?
-Accounts receivable
-Accounts payable
-Tracer
-Rejected claim.
Answer: Accounts receivable
◉ Which of the following is considered the final determination of
the issues involving settlement of an insurance claim?
-Processing
-Translation
-Adjudication
-Transmission.
WORKBOOK SOLVED QUESTIONS
COMPILATION
◉ 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.
Answer: Communicating with the front desk staff during a team
meeting about missing information in patient files
◉ Which of the following acts applies to the administrative
simplification guideline?
-HIPAA
-Deficit reduction act of 2005
-The patient protection and affordable care act 2009
,-National correct coding initiative of 1995.
Answer: HIPAA
◉ Which of the following is an example of a violation of an adult
patient's confidentiality?
-While reviewing a claim, the CBCS reads the diagnosis before
realizing that the patient is a neighbor
-A CBCS queries the physician about a diagnosis in a patient's
medical record
-The physician uses his home phone to discuss patient care with the
nursing staff
-Patient information was disclosed to the patient's parents without
consent.
Answer: Patient information was disclosed to the patient's parents
without consent
◉ Which of the following is the purpose of running an aging report
each month?
-If indicates the balances the patients owe the provider
-It indicates which patients have upcoming or missed appointment
-It indicates which claims are outstanding
-It indicates what the insurance company has paid for the provider's
services to a patient..
Answer: It indicates which claims are outstanding
,◉ Which of the following describes the status of a claim that does
not include the required preauthorization for a service?
-Delinquent (overdue)
-Denied
-Suspended
-Adjudicated (claim still being processed).
Answer: Denied
-Delinquent (overdue)
-Adjudicated (claim still being processed)
◉ Which of the following actions should the CBCS take to prevent
fraud and abuse in the medical office?
-Serviced procedure preauthorization
-Internal monitoring and auditing
-Utilization review
-Correct coding initiative.
Answer: Internal monitoring and auditing
◉ In an outpatient setting, which of the following forms is used as a
financial report of all services provided to patients?
-Encounter form
, -Patient account record
-CMS-1500 claim form
-Accounts receivable journal.
Answer: Patient account record (patient ledger, all transactions
between patient and the practice)
-Accounts receivable journal (Day sheet = chronological summary of
all transaction on a specific day)
◉ Patient charges that have not been paid will appear in which of
the following?
-Accounts receivable
-Accounts payable
-Tracer
-Rejected claim.
Answer: Accounts receivable
◉ Which of the following is considered the final determination of
the issues involving settlement of an insurance claim?
-Processing
-Translation
-Adjudication
-Transmission.
