AAPC CPB Practice Exam Questions and Answers Latest () (Verified ... file:///C:/Users/HP/Desktop/New%20folder/AAPC%20CPB%20Prac
AAPC CPB Practice Exam
Questions & Answers
1. Joe and Mary are a married couple and both carry insurance from their
employers. Joe was born on February 23, 1977 and Mary was born on April4,
1974. Using the birthday rule, who carries the primary insurance for their
children for billing?
A. Joe, because he is the male head of the household.
B. Mary, because her date of birth is the 4th and Joe's date of birth is the 23rd.
C. Mary, because her birth year is before Joe's birth year.
D. Joe, because his birth month and day are before Mary's birth month and
day.
Answer D. Joe, because his birth month and day are before Mary's birth month and
day.
2. Which type of managed care insurance allows patients to self-refer to
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out-of-network providers and pay a higher co-insurance/copay amount?
I. HMO
II. PPO
III. EPO
IV. POS
V. Capitation
A. II
B. IV
C. II and IV
D. II, III, and V
Answer C. II and IV
3. A patient covered by a PPO is scheduled for knee replacement surgery.The
biller contacts the insurance carrier to verify benefits and preauthorize the
procedure. The carrier verifies the patient has a $500 deductible which must be
met. After the deductible, the PPO will pay 80% of the claim.The contractedrate
for the procedure is $2,500. What is the patient's responsibility?
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A. $400
B. $500
C. $900
D. $1,600
Answer C. $900
4. When a nonparticipating provider files a claim for a patient to BC/BS, howis
the payment processed?
A. The payment is sent to the patient and the patient must pay the provider.
B. The payment is sent to the provider if the provider agrees to accept assign-
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ment.
C. The payment is sent to the provider regardless if he accepts assignment.
D. The claim is not paid because the provider is not participating in the plan.
Answer A.The payment is sent to the patient and the patient must pay the provider.
5. Which of the following TRICARE options is/are available to active duty
service members?
A. TRICARE Select
B. TRICARE Prime
C. TRICARE For Life
D. TRICAREYoung Adult
Answer B. TRICARE Prime
6. A Medicare card will list which of the following
I. Effective date of coverage
II. Home address
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AAPC CPB Practice Exam
Questions & Answers
1. Joe and Mary are a married couple and both carry insurance from their
employers. Joe was born on February 23, 1977 and Mary was born on April4,
1974. Using the birthday rule, who carries the primary insurance for their
children for billing?
A. Joe, because he is the male head of the household.
B. Mary, because her date of birth is the 4th and Joe's date of birth is the 23rd.
C. Mary, because her birth year is before Joe's birth year.
D. Joe, because his birth month and day are before Mary's birth month and
day.
Answer D. Joe, because his birth month and day are before Mary's birth month and
day.
2. Which type of managed care insurance allows patients to self-refer to
1 of 173 11/28/2024, 7:52
,AAPC CPB Practice Exam Questions and Answers Latest () (Verified ... file:///C:/Users/HP/Desktop/New%20folder/AAPC%20CPB%20Prac
out-of-network providers and pay a higher co-insurance/copay amount?
I. HMO
II. PPO
III. EPO
IV. POS
V. Capitation
A. II
B. IV
C. II and IV
D. II, III, and V
Answer C. II and IV
3. A patient covered by a PPO is scheduled for knee replacement surgery.The
biller contacts the insurance carrier to verify benefits and preauthorize the
procedure. The carrier verifies the patient has a $500 deductible which must be
met. After the deductible, the PPO will pay 80% of the claim.The contractedrate
for the procedure is $2,500. What is the patient's responsibility?
2 of 173 11/28/2024, 7:52
,AAPC CPB Practice Exam Questions and Answers Latest () (Verified ... file:///C:/Users/HP/Desktop/New%20folder/AAPC%20CPB%20Prac
A. $400
B. $500
C. $900
D. $1,600
Answer C. $900
4. When a nonparticipating provider files a claim for a patient to BC/BS, howis
the payment processed?
A. The payment is sent to the patient and the patient must pay the provider.
B. The payment is sent to the provider if the provider agrees to accept assign-
3 of 173 11/28/2024, 7:52
,AAPC CPB Practice Exam Questions and Answers Latest () (Verified ... file:///C:/Users/HP/Desktop/New%20folder/AAPC%20CPB%20Prac
ment.
C. The payment is sent to the provider regardless if he accepts assignment.
D. The claim is not paid because the provider is not participating in the plan.
Answer A.The payment is sent to the patient and the patient must pay the provider.
5. Which of the following TRICARE options is/are available to active duty
service members?
A. TRICARE Select
B. TRICARE Prime
C. TRICARE For Life
D. TRICAREYoung Adult
Answer B. TRICARE Prime
6. A Medicare card will list which of the following
I. Effective date of coverage
II. Home address
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