CBCS Practice Exam #3
1. A beneficiary of a Medicare/Medicaid crossover claim submitted by using a taking part
company is liable for which of the subsequent possibilities? - ANS-zero%
2. A biller will electronically publish a declare to the provider through which of the following?
- ANS-Direct information access
3. A billing and coding expert is reviewing a CMS-1500 claim shape. The mission of
advantages field has been checked sure. The checked box suggests which of the
following? - ANS-The company gets payment without delay from the payer.
4. A billing and coding professional should add modifier -50 to codes when reporting which
of the following? - ANS-A bilateral method
5. A billing and coding specialist have to enter the previous authorization variety at the
CMS-1500 claim shape wherein of the following blocks? - ANS-23
6. A declare is denied due to termination of insurance. Which of the following moves should
the billing and coding expert take subsequent? - ANS-Follow up with the patient to
determine contemporary call, deal with, and insurance provider for resubmission
7. A coroner's post-mortem is comprised of which of the following examinations? -
ANS-Gross exam
8. A established baby whose mother and father each have coverage insurance comes to
the clinic. The billing and coding expert uses the birthday rule to determine which
coverage coverage is number one. Which of the subsequent describes the birthday rule?
- ANS-The determine whose birthdate comes first inside the calendar 12 months
9. A taking part Blue Cross/Blue Shield (BC/BS) provider gets an evidence of benefits for a
affected person account. The charged quantity become $one hundred. BC/BS allowed
$eighty and implemented $forty to the affected person's annual deductible. BC/BS paid
the balance at 80%. How a good deal should the patient assume to pay? - ANS-$48
10. A affected person has met a Medicare deductible of $a hundred and fifty. The patient's
coinsurance is 20%, and the allowed quantity is $600. Which of the following is the
patient's out-of-pocket fee? - ANS-$one hundred twenty
11. A patient provides to the company with chest pain and shortness of breath. After an
surprising ECG end result, the issuer calls a cardiologist and summarizes the patient's
signs. What part of HIPAA permits the provider to speak to the cardiologist prior to
acquiring the patient's consent? - ANS-Title II
12. A doctor is shrunk with an coverage enterprise to just accept the allowed quantity. The
coverage organization permits $eighty of a $a hundred and twenty billed quantity, and
$50 of the deductible has not been met. How lots should the medical doctor write off the
affected person's account? - ANS-$40
13. A medical doctor ordered a comprehensive metabolic panel for a 70-year-antique
affected person who has Medicare as her number one insurance. Which of the
subsequent paperwork is needed so the patient is aware of she can be answerable for
price? - ANS-Advanced Beneficiary Notice
, 14. A prospective billing account audit prevents fraud with the aid of reviewing and
evaluating a finished declare shape with which of the subsequent files? - ANS-A billing
worksheet from the patient account
15. A provider performs an examination of a affected person's sore throat at some point of
an workplace visit. Which of the following describes the level of the exam? -
ANS-Problem-centered examination
16. A issuer gets a compensation from a 3rd-party payer followed by using which of the
subsequent documents? - ANS-Explanation of benefits
17. After a third-party payer validates a declare, which of the following takes place
subsequent? - ANS-Claim adjudication
18. After studying a provider's notes about a brand new patient, a coding professional
decides to code for an extended period of time than the real workplace go to. Which of
the following describes the specialist's motion? - ANS-Fraud
19. Behavior plays an crucial a part of being a group participant in a scientific exercise.
Which of the subsequent is the proper action for the billing and coding professional to
take? - ANS-Communicating with the the front desk group of workers all through a crew
meeting about lacking facts in affected person files
20. Block 17b on the CMS-1500 declare form have to listing which of the subsequent
records - ANS-Referring health practitioner's country wide issuer identifier (NPI) variety
21. For which of the subsequent time intervals have to the billing and coding professional
track unpaid claims before taking follow-up action? - ANS-30 days
22. HIPAA transaction standards follow to which of the subsequent entities? - ANS-Health
care clearinghouses
23. If a affected person has osteomyelitis, he has troubles with which of the subsequent
regions? - ANS-Bones and bone marrow
24. In 1995 and 1997, which of the following introduced documentation recommendations to
Medicare providers to make sure that services paid for have been furnished and were
medically vital? - ANS-CMS
25. In an outpatient setting, which of the following bureaucracy is used as a economic file of
all services provided to sufferers? - ANS-Patient account record
26. Medicare enforces obligatory submission of digital claims for maximum vendors. Which
of the subsequent carriers is allowed to post paper claims to Medicare? - ANS-A
provider's workplace with fewer than 10 full-time employees
27. On the CMS-1500 declare form, Blocks 1 through 13 consist of which of the following? -
ANS-The patient's demographics
28. On the CMS-1500 declare shape, blocks 14 through 33 contain statistics approximately
which of the following? - ANS-The affected person's situation and the issuer's records
29. Patient costs which have no longer been paid will appear wherein of the subsequent? -
ANS-Accounts receivable
30. The "><" image is used to suggest new and revised text aside from which of the
subsequent? - ANS-Procedure descriptors
31. The destruction of lesions the use of cryosurgery might use which of the following
treatments? - ANS-Cold treatment
1. A beneficiary of a Medicare/Medicaid crossover claim submitted by using a taking part
company is liable for which of the subsequent possibilities? - ANS-zero%
2. A biller will electronically publish a declare to the provider through which of the following?
- ANS-Direct information access
3. A billing and coding expert is reviewing a CMS-1500 claim shape. The mission of
advantages field has been checked sure. The checked box suggests which of the
following? - ANS-The company gets payment without delay from the payer.
4. A billing and coding professional should add modifier -50 to codes when reporting which
of the following? - ANS-A bilateral method
5. A billing and coding specialist have to enter the previous authorization variety at the
CMS-1500 claim shape wherein of the following blocks? - ANS-23
6. A declare is denied due to termination of insurance. Which of the following moves should
the billing and coding expert take subsequent? - ANS-Follow up with the patient to
determine contemporary call, deal with, and insurance provider for resubmission
7. A coroner's post-mortem is comprised of which of the following examinations? -
ANS-Gross exam
8. A established baby whose mother and father each have coverage insurance comes to
the clinic. The billing and coding expert uses the birthday rule to determine which
coverage coverage is number one. Which of the subsequent describes the birthday rule?
- ANS-The determine whose birthdate comes first inside the calendar 12 months
9. A taking part Blue Cross/Blue Shield (BC/BS) provider gets an evidence of benefits for a
affected person account. The charged quantity become $one hundred. BC/BS allowed
$eighty and implemented $forty to the affected person's annual deductible. BC/BS paid
the balance at 80%. How a good deal should the patient assume to pay? - ANS-$48
10. A affected person has met a Medicare deductible of $a hundred and fifty. The patient's
coinsurance is 20%, and the allowed quantity is $600. Which of the following is the
patient's out-of-pocket fee? - ANS-$one hundred twenty
11. A patient provides to the company with chest pain and shortness of breath. After an
surprising ECG end result, the issuer calls a cardiologist and summarizes the patient's
signs. What part of HIPAA permits the provider to speak to the cardiologist prior to
acquiring the patient's consent? - ANS-Title II
12. A doctor is shrunk with an coverage enterprise to just accept the allowed quantity. The
coverage organization permits $eighty of a $a hundred and twenty billed quantity, and
$50 of the deductible has not been met. How lots should the medical doctor write off the
affected person's account? - ANS-$40
13. A medical doctor ordered a comprehensive metabolic panel for a 70-year-antique
affected person who has Medicare as her number one insurance. Which of the
subsequent paperwork is needed so the patient is aware of she can be answerable for
price? - ANS-Advanced Beneficiary Notice
, 14. A prospective billing account audit prevents fraud with the aid of reviewing and
evaluating a finished declare shape with which of the subsequent files? - ANS-A billing
worksheet from the patient account
15. A provider performs an examination of a affected person's sore throat at some point of
an workplace visit. Which of the following describes the level of the exam? -
ANS-Problem-centered examination
16. A issuer gets a compensation from a 3rd-party payer followed by using which of the
subsequent documents? - ANS-Explanation of benefits
17. After a third-party payer validates a declare, which of the following takes place
subsequent? - ANS-Claim adjudication
18. After studying a provider's notes about a brand new patient, a coding professional
decides to code for an extended period of time than the real workplace go to. Which of
the following describes the specialist's motion? - ANS-Fraud
19. Behavior plays an crucial a part of being a group participant in a scientific exercise.
Which of the subsequent is the proper action for the billing and coding professional to
take? - ANS-Communicating with the the front desk group of workers all through a crew
meeting about lacking facts in affected person files
20. Block 17b on the CMS-1500 declare form have to listing which of the subsequent
records - ANS-Referring health practitioner's country wide issuer identifier (NPI) variety
21. For which of the subsequent time intervals have to the billing and coding professional
track unpaid claims before taking follow-up action? - ANS-30 days
22. HIPAA transaction standards follow to which of the subsequent entities? - ANS-Health
care clearinghouses
23. If a affected person has osteomyelitis, he has troubles with which of the subsequent
regions? - ANS-Bones and bone marrow
24. In 1995 and 1997, which of the following introduced documentation recommendations to
Medicare providers to make sure that services paid for have been furnished and were
medically vital? - ANS-CMS
25. In an outpatient setting, which of the following bureaucracy is used as a economic file of
all services provided to sufferers? - ANS-Patient account record
26. Medicare enforces obligatory submission of digital claims for maximum vendors. Which
of the subsequent carriers is allowed to post paper claims to Medicare? - ANS-A
provider's workplace with fewer than 10 full-time employees
27. On the CMS-1500 declare form, Blocks 1 through 13 consist of which of the following? -
ANS-The patient's demographics
28. On the CMS-1500 declare shape, blocks 14 through 33 contain statistics approximately
which of the following? - ANS-The affected person's situation and the issuer's records
29. Patient costs which have no longer been paid will appear wherein of the subsequent? -
ANS-Accounts receivable
30. The "><" image is used to suggest new and revised text aside from which of the
subsequent? - ANS-Procedure descriptors
31. The destruction of lesions the use of cryosurgery might use which of the following
treatments? - ANS-Cold treatment
