BMC ANSWERS 2026 THEORY AND
APPLICATION REVIEW QUESTIONS ANSWERS
VERIFIED GUIDE
◉ 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.
Answer: Adjustment column of the credits
◉ 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.
Answer: The deductible is the patient's responsibility
,◉ Which of the following color formats allows optical scanning of
the CMS-1500 claim form?
-Red
-Blue
-Green
-black.
Answer: red
◉ 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.
Answer: UB-04
◉ 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.
,Answer: The number is needed to identify the provider
◉ Which of the following terms describes when a plan pays 70% of
the allowed amount and the patient pays 30%?
-Coinsurance
-Deductible
-Premium
-copayment.
Answer: coinsurance
◉ 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..
Answer: the claim requires an attachment
◉ 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.
Answer: provider
◉ 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.
Answer: $40
◉ 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.
Answer: Guidelines prior to each section
APPLICATION REVIEW QUESTIONS ANSWERS
VERIFIED GUIDE
◉ 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.
Answer: Adjustment column of the credits
◉ 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.
Answer: The deductible is the patient's responsibility
,◉ Which of the following color formats allows optical scanning of
the CMS-1500 claim form?
-Red
-Blue
-Green
-black.
Answer: red
◉ 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.
Answer: UB-04
◉ 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.
,Answer: The number is needed to identify the provider
◉ Which of the following terms describes when a plan pays 70% of
the allowed amount and the patient pays 30%?
-Coinsurance
-Deductible
-Premium
-copayment.
Answer: coinsurance
◉ 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..
Answer: the claim requires an attachment
◉ 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.
Answer: provider
◉ 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.
Answer: $40
◉ 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.
Answer: Guidelines prior to each section
