CBCS Practice Test Questions with Complete Solutions.

CBCS practice test Questions with Correct Rationales A patient's health plan is referred to as the payer of last resort. The patient is covered by which of the following health plans? Medicaid CHAMPA Medicare TRICARE - ANS: Medicaid 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 - ANS: 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 - ANS: 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 - ANS: 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 - ANS: 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 - ANS: 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 - ANS: 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. - ANS: 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 - ANS: 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 - ANS: $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 - ANS: Guidelines prior to each section Which of the following blocks should the billing and coding specialist complete the CMS 1500 claims form for procedure, services or supplies? -Block 12 -Block 2 -Block 24D -Block 24J - ANS: Block 24D -Block 12 (patient's authorization block -Block 2 ( patient's name) -Block 24J ( for the rendering provider) Which of the following blocks requires the patient's authorization to release medical information to process a claim? Block 12 Block 13 Block 27 Block 31 - ANS: Block 12 - Block 13 patient authorization for benefits required for third party payer - Block 27 accepting assignment of benefits - Block 31 (treating physician) Which of the following steps would be part of a physician's practice compliance program? -HIPAA compliance audit -Physician recruitment -Internal monitoring and auditing -Notice of privacy practice - ANS: Internal monitoring and auditing 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 - ANS: 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 - ANS: 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 - ANS: 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. - ANS: It indicates which claims are outstanding