CPB PRACTICE EXAM QUESTIONS AND ANSWERS WITH SOLUTIONS 2024

CPB PRACTICE EXAM QUESTIONS AND
ANSWERS WITH SOLUTIONS 2024
WHO IS COVERED BY CHAMPVA?
O O O O




A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES
O O O O O O O O O O




B) ACTIVE DUTY MILITARY AND THEIR FAMILIES
O O O O O O




C) RETIRED MILITARY AND THEIR FAMILIES
O O O O O




D) ACTIVE DUTY MILITARY OVER THE AGE OF 65 - ANSWER A) VETERANS WITH SERVICE -
O O O O O O O O O O O O O O O


CONNECTED DISABILITIES AND THEIR FAMILIES
O O O O O




RATIONALE: THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIR
O O O O O O O O O O O O


S (CHAMPVA) COVERS VETERANS WHO ARE PERMANENTLY AND TOTALLY DISABLED DUE TO A SERVICE-
O O O O O O O O O O O O O


RELATED DISABILITY AND THEIR SPOUSE AND CHILDREN.
O O O O O O




PATIENT IS BROUGHT TO THE LOCAL URGENT CARE AFTER FALLING FROM A LADDER WHILE HANGING E
O O O O O O O O O O O O O O O


XTERIOR LIGHTS ON HIS HOUSE. X- O O O O O


RAYS REVEALED A CLOSED FRACTURE OF HIS LEFT FEMUR. THE PATIENT IS COVERED BY HIS EMPLOYER'S
O O O O O O O O O O O O O O O O


GROUP HEALTH PLAN AND HE ALSO HAS A HOMEOWNER'S LIABILITY INSURANCE POLICY. WHICH INSUR
O O O O O O O O O O O O O


ANCE SHOULD BE BILLED?
O O O




A) THE HOMEOWNER'S INSURANCE FIRST, FOLLOWED BY THE GROUP HEALTH PLAN
O O O O O O O O O O




B) THE EMPLOYER'S GROUP HEALTH PLAN
O O O O O




C) THE HOMEOWNER'S INSURANCE ONLY
O O O O




D) FILE THE EMPLOYER'S GROUP HEALTH PLAN AS PRIMARY AND LIST THE HOMEOWNER'S INSURANCE
O O O O O O O O O O O O O O


AS SECONDARY. - ANSWER B) THE EMPLOYER'S GROUP HEALTH PLAN
O O O O O O O O O




RATIONALE: THE HEALTH INSURANCE PLAN IS BILLED FIRST AND THEN THROUGH THE PROCESS OF SUBR
O O O O O O O O O O O O O O


OGATION IT WILL BE DETERMINED IF A LIABILITY PAYER SHOULD BE CONSIDERED PRIMARY.
O O O O O O O O O O O O




3. PRIVATE COMPANIES CONTRACT WITH CMS TO ADMINISTER:
O O O O O O O




A) MEDICARE PART A & B
O O O O O

,B) MEDICARE PART B
O O O




C) MEDICARE PART C
O O O




D) MEDICARE PART A, B, & C - ANSWER D) MEDICARE PART A, B, AND C
O O O O O O O O O O O O O O O




RATIONALE: MEDICARE PART A, B, AND C ARE ALL ADMINISTERED BY PRIVATE COMPANIES THAT CONTR
O O O O O O O O O O O O O O


ACT WITH CMS AS MEDICARE ADMINISTRATIVE CONTRACTORS OR MACs.
O O O O O O O O




WHAT IS A CO-PAYMENT?
O O O O




A) AN AMOUNT PAID EVERY MONTH BY THE POLICYHOLDER TO MAINTAIN HEALTH INSURANCE COVERA
O O O O O O O O O O O O O


GE

B) A PERCENTAGE OF THE ALLOWED AMOUNT THAT THE PATIENT IS RESPONSIBLE FOR.
O O O O O O O O O O O O




C) A FLAT AMOUNT PAID TO THE HEALTHCARE PROVIDER WHEN THE POLICYHOLDER IS SEEN FOR AN OF
O O O O O O O O O O O O O O O O


FICE VISIT.
O




D) THE ADJUSTED AMOUNT BASED ON THE INSURANCE POLICY REQUIREMENT. -
O O O O O O O O O O


OANSWER C) A FLAT AMOUNT PAID TO THE HEALTHCARE PROVIDER WHEN THE POLICY HOLDER IS SEEN
O O O O O O O O O O O O O O O O


FOR AN OFFICE VISIT.
O O O




WHICH OF THE FOLLOWING STATEMENTS IS TRUE REGARDING THE NON-
O O O O O O O O O


PAR MEDICARE ALLOWED FEE SCHEDULE?
O O O O




A) THE NON-
O O


PAR PROVIDER CAN BILL THE PATIENT THE DIFFERENCE BETWEEN THE CHARGE AND THE MEDICARE ALL
O O O O O O O O O O O O O O


OWABLE.

B) THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-PAR MEDICARE PHYSICIAN FEE SCHEDULE
O O O O O O O O O O O O O




C) THE NON-PAR PHYSICIAN FEE SCHEDULE IS 115% OF THE PAR MEDICARE PHYSICIAN FEE SCHEDULE
O O O O O O O O O O O O O O




D) THE NON-PAR LIMITING CHARGE IS 95% OF THE PAR MEDICARE PHYSICIAN FEE SCHEDULE. -
O O O O O O O O O O O O O O


OANSWER B) THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-
O O O O O O O O O O


PAR MEDICARE PHYSICIAN FEE SCHEDULE.
O O O O O




RATIONALE: PER CMS, THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-
O O O O O O O O O O O


PAR MEDICARE PHYSICIAN FEE SCHEDULE.
O O O O

, WHAT IS A MEDIGAP POLICY?
O O O O




A) A POLICY THAT COVERS HEALTHCARE SERVICES THAT MEDICARE DOES NOT COVER.
O O O O O O O O O O O




B) A POLICY THAT WILL NOT REIMBURSE FOR OUT-OF-POCKET COSTS NOT COVERED BY MEDICARE
O O O O O O O O O O O O O




C) A SUPPLEMENTAL INSURANCE OFFERED BY CMS.
O O O O O O




D) A POLICY REQUIRED BY MEDICARE. -
O O O O O O


ANSWER A) A POLICY THAT COVERS HEALTHCARE SERVICES THAT MEDICARE DOES NOT COVER.
O O O O O O O O O O O O O




MEDICARE PART A IS AVAILABLE TO INDIVIDUALS UNDER THE AGE OF 65 WHO HAVE:
O O O O O O O O O O O O O




A) DIABETES MELLITUS TYPE I OR II
O O O O O O




B) CKD (CHRONIC KIDNEY DISEASE)
O O O O




C) ESRD AND MEET CERTAIN REQUIREMENTS
O O O O O




D) ANY CHRONIC HEALTH CONDITION - ANSWER C) ESRD AND MEET CERTAIN REQUIREMENTS.
O O O O O O O O O O O O




RATIONALE: MEDICARE PART A COVERAGE IS AVAILABLE TO INDIVIDUALS BELOW THE AGE OF 65 WHO H
O O O O O O O O O O O O O O O


AVE; 1) RECEIVED SOCIAL SECURITY OR RRB DISABILITY BENEFITS FOR 24 MONTHS, 2) END-
O O O O O O O O O O O O O


STAGE RENAL DISEASE AND MEET CERTAIN REQUIREMENTS
O O O O O O




WHICH OF THE FOLLOWING STATEMENTS IS TRUE REGARDING MEDICAID?
O O O O O O O O




A) MEDICAID ELIGIBILITY POLICIES ARE THE SAME FOR STATES OF SIMILAR SIZE AND GEOGRAPHIC REGIO
O O O O O O O O O O O O O O


N.

B) MEDICAID ELIGIBILITY IS CLEAR AND CONSISTENT FROM STATE TO STATE
O O O O O O O O O O




C) MEDICAID PROGRAMS RECEIVE MATCHING FFEDERAL FUNDING ONLY IF CERTAIN HEALTHCARE SERVI
O O O O O O O O O O O


CES ARE PROVIDED TO ELIGIBLE INDIVIDUALS.
O O O O O




D) MEDICAID PROGRAMS MUST PROVIDE MEDICAL ASSISTANCE FOR ALL POOR PERSONS. -
O O O O O O O O O O O


ANSWER C) MEDICAID PROGRAMS RECEIVE MATCHING FEDERAL FUNDING ONLY IF CERTAIN HEALTHCA
O O O O O O O O O O O O


RE SERVICES ARE PROVIDED TO ELIGBLE INDIVIDUALS.
O O O O O O