AAPC Certified Professional Biller (CPB)® certification Practice Exam
2025 verified questions and answer
Joe and Mary are a married couple and both carry insurance from their
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employers. Joe was born on February 23, 1977 and Marywas born onApril 4,
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1974. Using the birthday rule, who carries the primary insurance for their
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children for billing?
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A. Joe,because heis the male head of the household. kk kk kk kk kk kk kk kk kk
B. Mary, because her date of birth is the 4th andJoe's date of birth is the 23rd.
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C. Mary,because her birth year is before Joe's birth year. kk kk kk kk kk kk kk kk kk
D. Joe, because his birth month and dayare before Mary's birth month and day. -
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The correct answer is D. Joe, because his birth month and day are before
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Mary's birth month and day.
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Which type of managed careinsurance allows patients to self-refer to out-of-
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network providers and pay a higher co-insurance/copay amount? kk kk kk kk kk kk kk
I. HMO
II. PPO
III. EPO
IV. POS
V. Capitation
A. II
B. IV
C. II and IV kk kk
D. II, III, and V - The correct answer is C. II and IV
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A patient covered by a PPO is scheduled for knee replacement surgery. The
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biller contacts the insurance carrier to verifybenefits and preauthorize the
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procedure. The carrier verifies the patient has a $500 deductible which must be
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met. After the deductible, the PPO will pay 80% of the claim. The contracted rate
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for the procedure is $2,500. What is the patient's responsibility?
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A. $400
2025 verified questions and answer
Joe and Mary are a married couple and both carry insurance from their
kk kk kk kk kk kk kk kk kk kk kk kk
employers. Joe was born on February 23, 1977 and Marywas born onApril 4,
kk kk kk kk kk kk kk kk kk kk kk kk kk kk kk
1974. Using the birthday rule, who carries the primary insurance for their
kk kk kk kk kk kk kk kk kk kk kk kk
children for billing?
kk kk kk
A. Joe,because heis the male head of the household. kk kk kk kk kk kk kk kk kk
B. Mary, because her date of birth is the 4th andJoe's date of birth is the 23rd.
kk kk kk kk kk kk kk kk kk kk kk kk kk kk kk kk
C. Mary,because her birth year is before Joe's birth year. kk kk kk kk kk kk kk kk kk
D. Joe, because his birth month and dayare before Mary's birth month and day. -
kk kk kk kk kk kk kk kk kk kk kk kk kk kk
The correct answer is D. Joe, because his birth month and day are before
kk kk kk kk kk kk kk kk kk kk kk kk kk kk
Mary's birth month and day.
kk kk kk kk kk
Which type of managed careinsurance allows patients to self-refer to out-of-
kk kk kk kk kk kk kk kk kk kk kk
network providers and pay a higher co-insurance/copay amount? kk kk kk kk kk kk kk
I. HMO
II. PPO
III. EPO
IV. POS
V. Capitation
A. II
B. IV
C. II and IV kk kk
D. II, III, and V - The correct answer is C. II and IV
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A patient covered by a PPO is scheduled for knee replacement surgery. The
kk kk kk kk kk kk kk kk kk kk kk kk
biller contacts the insurance carrier to verifybenefits and preauthorize the
kk kk kk kk kk kk kk kk kk kk kk
procedure. The carrier verifies the patient has a $500 deductible which must be
kk kk kk kk kk kk kk kk kk kk kk kk kk
met. After the deductible, the PPO will pay 80% of the claim. The contracted rate
kk kk kk kk kk kk kk kk kk kk kk kk kk kk kk
for the procedure is $2,500. What is the patient's responsibility?
kk kk kk kk kk kk kk kk kk kk
A. $400
