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Exam (elaborations)

CBCS Practice Test Questions 2025. (Correct Answers)

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CBCS Practice Test Questions 2025. (Correct Answers)

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NHA CBCS
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Uploaded on
January 6, 2025
Number of pages
65
Written in
2024/2025
Type
Exam (elaborations)
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CBCS Practice Test Questions 2025.
(Correct Answers)




A patient's health plan is referred to as the payer of last resort. The patient is covered by which of the
w w w w w w w w w w w w w w w w w w w w w




following health plans? w w




Medicaid

CHAMPA

Medicare

TRICARE - correct answer Medicaid
w w w w




A provider charged $500 to a claim that had an allowable amount of $400. In which of the following columns
w w w w w w w w w w w w w w w w w w w w




should the CBCS apply the non allowed charge?
w w w w w w w




-Reference column (For notations) w w w




-Description column w




-Payment column w




-Adjustment column of the credits - correct answer Adjustment column of the credits
w w w w w w w w w w w w




Which of the following statements is correct regarding a deductible?
w w w w w w w w w




-Coinsurance is a type of deductible w w w w w




-The physician should write off the deductible
w w w w w w

,-The insurance company pays for the deductible
w w w w w w




-The deductible is the patient's responsibility - correct answer The deductible is the patient's responsibility
w w w w w w w w w w w w w w




Which of the following color formats allows optical scanning of the CMS-1500 claim form?
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-Red

-Blue

-Green

-black - correct answer red
w w w w




Ambulatory surgery centers, home health and hospice organizations use the ______.
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-CMS-1500 claim form w w




-UB-04 claim form w w




-Advance Beneficiary notice w w




-First report of injury form - correct answer UB-04
w w w w w w w w




Claims that are submitted without an NPI number will delay payment to the provider because ______.
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-The number is the patient' id number
w w w w w w




-The number is needed to identify the provider
w w w w w w w




-Is is used as a claim number
w w w w w w




-It is used as a pre authorization number - correct answer The number is needed to identify the provider
w w w w w w w w w w w w w w w w w w




Which of the following terms describes when a plan pays 70% of the allowed amount and the patient pays
w w w w w w w w w w w w w w w w w w w




30%?

-Coinsurance

-Deductible

-Premium

-copayment - correct answer coinsurance w w w w




Which of the following indicates a claim should be submitted on paper instead of electronically?
w w w w w w w w w w w w w w

,-The software claims review process indicates the claim is not complete
w w w w w w w w w w




-The claim needs authorization
w w w




-The claim requires an attachment
w w w w




-The practice management software is non functional. - correct answer the claim requires an attachment
w w w w w w w w w w w w w w




On a remittance advice form, which of the following is responsible for writing off the difference between the
w w w w w w w w w w w w w w w w w w




amount billed and the amount allowed by the agreement?
w w w w w w w w




-Provider

-Insurance company w




-Patient

-Third party payer - correct answer provider
w w w w w w




A physician is contracted with an insurance company to accept the amount. The insurance company allows
w w w w w w w w w w w w w w w w




$80 of a $120 billed amount, and $50 of the deductible has not been met. How much should the physician
w w w w w w w w w w w w w w w w w w w w




write off the patient's account?
w w w w




-$40

-$15

-$0

-$50 - correct answer $40
w w w w




The unlisted codes can be found in which of the following locations in the CPT manual?
w w w w w w w w w w w w w w w




-Appendix L w




-Guidelines prior to each section w w w w




-End of each body system
w w w w




-Table of contents - correct answer Guidelines prior to each section
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Which of the following blocks should the billing and coding specialist complete the CMS 1500 claims form for
w w w w w w w w w w w w w w w w w w




procedure, services or supplies? w w w




-Block 12 w w




-Block 2 w w

, -Block 24D w




-Block 24J - correct answer Block 24D
w w w w w w




-Block 12 (patient's authorization block
w w w w




-Block 2 ( patient's name)
w w w w




-Block 24J ( for the rendering provider)
w w w w w w




Which of the following blocks requires the patient's authorization to release medical information to process
w w w w w w w w w w w w w w w




a claim?
w




Block 12w




Block 13w w




Block 27w w




Block 31 - correct answer Block 12
w w w w w w




- Block 13 patient authorization for benefits required for third party payer
w w w w w w w w w w w




- Block 27 accepting assignment of benefits
w w w w w w




- Block 31 (treating physician)
w w w w




Which of the following steps would be part of a physician's practice compliance program?
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-HIPAA compliance audit
w w




-Physician recruitment w




-Internal monitoring and auditing w w w




-Notice of privacy practice - correct answer Internal monitoring and auditing
w w w w w w w w w w




Behavior plays an important part of being a team player in a medical practice. Which of the following is an
w w w w w w w w w w w w w w w w w w w w




appropriate action for the CBCS to take? w w w w w w




-Reprimanding another staff member during a team meeting for displaying a bad attitude toward a patient
w w w w w w w w w w w w w w w




-Looking in the medical record of a friend who receives services at the office
w w w w w w w w w w w w w




-Communicating with the front desk staff during a team meeting about missing information in patient files
w w w w w w w w w w w w w w w




-Questioning the nurse about the provider documentation in the medical record - correct answer
w w w w w w w w w w w w w w




Communicating with the front desk staff during a team meeting about missing information in patient files
w w w w w w w w w w w w w w w

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