CPB Certified Professional Biller Certification exam questions with correct answers

CPB Certified Professional Biller Certification exam questions with correct answers Abuse - Correct Answers-Actions inconsistent with accepted, sound medical business or fiscal practice Accept Assignment - Correct Answers-Provider accepts as payment in full whatever is paid on the cliam by the payer (except for any copayment and or coinsurance amounts.) Accounts Receivable - Correct Answers-The amount owed to a business for services or goods provided. Accounts Receivable Aging Report - Correct Answers-Shows the status (by date) of outstanding claims from each payer, as well as payments due from patients. Accounts Receivable Management - Correct Answers-Assists Providers in the collection of appropriate reimbursement for services rendered; include functions such as insurance verification/eligibility and preauthorization of services. Accreditation - Correct Answers-Voluntary Process that a healthcare facility or organization (e.g. hospital or manged care plan) undergoes to demonstarte that it has met standards beyond those required by law. Adjudication - Correct Answers-Judicial dispuite resolution process in which an appeals board makes a final determination. Adjusted Claim - Correct Answers-payment correction resulting in additional payment(s) to the provider. Advance Beneficiary Notice (ABN) - Correct Answers-Document that acknowledges patient responsiblity for payment if Medicare denies the cliam. Adverse Effect - Correct Answers-Also called adverse reaction; the appearance of a pathologic condition due to ingestion r exposure to a chemical substance properly administered or taken. Adverse Reaction - Correct Answers-Also called adverse effect; the appearance of a pathologic condition due to ingestion r exposure to a chemical substance properly administered or taken. Adverse Selection - Correct Answers-Covering members who are sicker then the general population. Allowable Charge - Correct Answers-see limiting charge; maximum fee a physician may charge. Allowed Charge - Correct Answers-The Maximum amount the payer will reimburse for each procedure or service, according to the patients policy. All Patient Diagnosis-Related Group (AP-DRG) - Correct Answers-DRG system adapted for use by third-party payers to reimburse hospitals for inpatient care provided to non-Medicare beneficiaries (e.g. Blue Cross Blue Shield, commercial health plans, TRICARE); DRG assignment is based on intensity of resources. All Patient Refined Diagnosis-Related Group (ARP-DRG) - Correct Answers-Adopted by Medicare in 2008 to reimburse hospitals for inpatient care provided to Medicare beneficiaries; expanded originial DRG system (based on intensity of resources) to add two subclasses to each DRG that adjusts Medicare inpatient hospital reimbursement rates for severity of illness (SOI) (extent of physiological decompensation or organ system loss of function) and risk of mortality (ROM) (likelihood of dying); each subclass, in turn, is subdivided into four areas: (1) minor, (2) moderate, (3) major, (4) extreme. Ambulance Fee Schedule - Correct Answers-Payment system for ambulance services provided to Medicare Beneficiaries. Ambulatory Payment Classification (APC) - Correct Answers-Prospective payment system used to calculate reimbursement for outpatient care according to similar clinical characteristics and in terms of resources required. Ambulatory Surgical Center (ASC) - Correct Answers-State Licensed Medicare-certified supplier (not provider) of sur