AAPC CPB - Practice Exam A/ Questions with
Verified Answers.
When a patient has Medicare primary and AARP as Medigap, what is entered on
the CMS-1500 claim form in item 9d for the Insurance Plan Name or Program
Name for Medicare to cross over the claim?
A. Plan name followed by "MEDIGAP"
B. Plan Payer ID followed by "MEDIGAP"
C. COBA Medigap claim-based identifier (ID)
D. Leave blank - Answer: C. COBA Medigap claim-based identifier (ID)
Which guidelines must all billing personnel be knowledgeable about in order to
ensure compliance with Medicaid programs?
A. Federal guidelines
B. State guidelines
,C. Both A and B
D. None - Answer: C. Both A and B
Which of the following services is covered by Early and Periodic Screening,
Diagnostic, and Treatment (EPSDT)?
A. Family planning
B. Obstetric care
C. Pediatric checkups
D. Emergency department visits - Answer: C. Pediatric checkups
A female patient who was involved in an auto accident presents to the emergency
department (ED) for evaluation. She does not have any complaints. The provider
evaluates her and determines there are no injuries. The provider informs the
patient to come back to the ED or see her primary care physician if she develops
any symptoms. How is the claim processed for this encounter?
A. The medical insurance is billed primary and the auto insurance is billed
secondary.
B. The auto insurance is billed primary and the medical insurance is billed
secondary.
C. Bill the medical insurance first to receive a denial and then submit with the
remittance advice to the auto insurance.
, D. Bill only the medical insurance because the auto insurance only covers damage
to the vehicle, not medical expenses. - Answer: B. The auto insurance is billed
primary and the medical insurance is billed secondary.
What forms need to be submitted when billing for a work-related injury?
A. Progress reports, and WC-1500 claim form
B. UB-04
C. First Report of Injury form and an itemized statement
D. First Report of Injury form, progress reports, and CMS-1500 claim form -
Answer: D. First Report of Injury form, progress reports, and CMS-1500 claim form
A document provided to Medicare patients explaining their financial responsibility
if Medicare denies a service is a(n):
A. Notice of Financial Liability
B. Advance Beneficiary Notice
C. Insurance waiver
D. Explanation of Benefits - Answer: B. Advance Beneficiary Notice
What is an Accountable Care Organization (ACO)?
A. Groups of doctors, hospitals, and other health care providers who coordinate
high quality care to Medicare patients.
B. An insurance carrier that provides a set fee based on the diagnosis of the
patient.
Verified Answers.
When a patient has Medicare primary and AARP as Medigap, what is entered on
the CMS-1500 claim form in item 9d for the Insurance Plan Name or Program
Name for Medicare to cross over the claim?
A. Plan name followed by "MEDIGAP"
B. Plan Payer ID followed by "MEDIGAP"
C. COBA Medigap claim-based identifier (ID)
D. Leave blank - Answer: C. COBA Medigap claim-based identifier (ID)
Which guidelines must all billing personnel be knowledgeable about in order to
ensure compliance with Medicaid programs?
A. Federal guidelines
B. State guidelines
,C. Both A and B
D. None - Answer: C. Both A and B
Which of the following services is covered by Early and Periodic Screening,
Diagnostic, and Treatment (EPSDT)?
A. Family planning
B. Obstetric care
C. Pediatric checkups
D. Emergency department visits - Answer: C. Pediatric checkups
A female patient who was involved in an auto accident presents to the emergency
department (ED) for evaluation. She does not have any complaints. The provider
evaluates her and determines there are no injuries. The provider informs the
patient to come back to the ED or see her primary care physician if she develops
any symptoms. How is the claim processed for this encounter?
A. The medical insurance is billed primary and the auto insurance is billed
secondary.
B. The auto insurance is billed primary and the medical insurance is billed
secondary.
C. Bill the medical insurance first to receive a denial and then submit with the
remittance advice to the auto insurance.
, D. Bill only the medical insurance because the auto insurance only covers damage
to the vehicle, not medical expenses. - Answer: B. The auto insurance is billed
primary and the medical insurance is billed secondary.
What forms need to be submitted when billing for a work-related injury?
A. Progress reports, and WC-1500 claim form
B. UB-04
C. First Report of Injury form and an itemized statement
D. First Report of Injury form, progress reports, and CMS-1500 claim form -
Answer: D. First Report of Injury form, progress reports, and CMS-1500 claim form
A document provided to Medicare patients explaining their financial responsibility
if Medicare denies a service is a(n):
A. Notice of Financial Liability
B. Advance Beneficiary Notice
C. Insurance waiver
D. Explanation of Benefits - Answer: B. Advance Beneficiary Notice
What is an Accountable Care Organization (ACO)?
A. Groups of doctors, hospitals, and other health care providers who coordinate
high quality care to Medicare patients.
B. An insurance carrier that provides a set fee based on the diagnosis of the
patient.
