EXAM A 2025. (CORRECT ANSWERS)
Which of the following is considered the final determination of the issues involving the settlement of an
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insurance claim? - correct answer Adjudication - is the process of putting an insurance claim through a series
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of edits for final determination.
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Chapter 4 q
A form that contains charges, DOS, CPT codes, fees, and copayment information is called which of the
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following? - correct answer Encounter form is a form that contains charges, DOS, CPT code, ICD codes, fees,
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and copayment information.
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A patient comes to the hospital for an inpatient procedure. Which of the following hospital staff members is
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responsible for the initial patient interview, obtaining demographic and insurance information, and
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documenting the chief complaint? - correct answer Admitting these duties clerk has Chapter 3
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Which of the following privacy measures ensures protected health information (PHI)? - correct answer Using
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data encryption software on office workstations - encryption software ensures that electronically
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transmitted health information cannot be read by third parties. This privacy measure guarantees PHI.
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Chapter 1 q
Which of the following planes divide the body into left and right? - correct answer Sagittal plane divides the
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body into right and left sections
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, Which of the following provisions ensures that an insured's benefits from all insurance companies do not
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exceed 100% of allowable medical expenses? - correct answer Coordination of benefits ensures that the
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insured benefits from all insured companies do not exceed 100% of allowable medical expenses.
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Which of the following actions should be taken first when reviewing a delinquent claim? - correct answer
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Verify the age of the account is the first action.
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Which of the following is the advantage of electronic claim submission? - correct answer Claims are expedited
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- submitting claims electronically is faster than submitting paper claims.
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Which of the following components of an explanation of benefits expedites the process of a phone appeal? -
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correct answer Claim control number expedites the process of a phone appeal.
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Chapter 4 q
The standard medical abbreviation "ECG" refers to a test used to assess which of the following body systems?
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- correct answer Cardiovascular system- which is a test that checks for problems with the electrical activity of
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the heart. q
Chapter 5 q
Which of the following actions by a billing coding specialist (bcs) would be considered fraud? - correct answer
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Billing for a service not provided is considered fraud and can result in fines for the bcs and the physician page 6
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The "> <" symbol is used to indicate new and revised text other than which of the following? - correct answer
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Procedures descriptors Chapter 5 q q q
On the CMS-1500 claim form, blocks 14 through 33 contain information about which of the following? -
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correct answer The patient's condition and the provider's information are found on the CMS-1500 at blocks
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14 - 33 page 21
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