CBCS practice test Questions with Correct Rationales

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