NHA CBCS What to Study from The Baseline Practice Test Part 2, Certified Billing and Coding Specialist (CBCS) Study Guide 3.1 NHA Questions with Correct Answers 2025

NHA CBCS What to Study from The Baseline Practice
Test Part 2, Certified Billing and Coding Specialist
(CBCS) Study Guide 3.1 NHA Questions with Correct
Answers 2025
InsuranceBEligibilityBandBOtherBPayerBRequirements:BDifferentiateBamongBwhat?B-BCORRECTBANSWERB-
DifferentiateBamongBprimary,Bsecondary,BandBtertiaryBinsuranceBplansBtoBdetermineBtheBfilingBorderBofBcla
imsBandBupdateBCoordinationBofBBenefitsB(COB)Binformation.



InsuranceBEligibilityBandBOtherBPayerBRequirements:BVerifyBwhat?B-BCORRECTBANSWERB-
VerifyBpatientBinsuranceBinformationBandBensureBcollectionBofBallBpertinentBdocumentationB(e.g.,Bdemogr
aphicBinformation,BinsuranceBcards,Bidentification,Bauthorizations).



InsuranceBEligibilityBandBOtherBPayerBRequirements:BalsoBverifyBwhat?B-BCORRECTBANSWERB-
alsoBverifyBinsuranceBeligibilityBtoBdetermineBbenefits,BapplicableBcopayments,Bdeductibles,BandBcoinsura
nceBdueBfromBpatient.



TheBRevenueBCycleBandBRegulatoryBCompliance:BIntegratesBwhat?B-BCORRECTBANSWERB-
IntegratesBrevenueBcycleBconceptsBwithBknowledgeBofBbusinessBandBpayerBrequirementsBtoBsupportBaccur
ateBcodingBandBtimelyBreimbursement.



TheBRevenueBCycleBandBRegulatoryBCompliance:BReleasesBPHIBwhenB-BCORRECTBANSWERB-
TheBRevenueBCycleBandBRegulatoryBCompliance:BReleaseBPHIBwhenBwhenBrequiredBinBaccordanceBwithBth
eBHealthBInsuranceBPortabilityBandBAccountabilityBActB(HIPAA)BandBfacilityBpolicy.



TheBRevenueBCycleBandBRegulatoryBCompliance:BMaintainBwhat?B-BCORRECTBANSWERB-
MaintainBconfidentialityBandBsecurityBofBprotectedBhealthBinformationB(PHI).



TheBRevenueBCycleBandBRegulatoryBCompliance:BEnsuresBwhat?B-BCORRECTBANSWERB-
EnsuresBcomplianceBwithBfederalBlaws,Bregulations,BandBguidelinesBandBhelpBpreventBfraudBandBabuseBbyB
adheringBtoBbillingBpolicies,BcodingBrules,BandBconventionsBtoBsubmitBcleanBandBaccurateBclaims.



TheBRevenueBCycleBandBRegulatoryBCompliance:BAlsoBEnsuresBwhat?B-BCORRECTBANSWERB-
complianceBwithBfederalBlaws,Bregulations,BandBguidelinesBandBhelpBpreventBfraudBandBabuseBbyBadhering
BtoBbillingBpolicies,BcodingBrules,BandBconventionsBtoBsubmitBcleanBandBaccurateBclaims.

, TheBRevenueBCycleBandBRegulatoryBCompliance:BClearlyBandBaccuratelyBcommunicateBwithBwho?B-
BCORRECTBANSWERB-

ClearlyBandBaccuratelyBcommunicateBwithBstakeholdersB(e.g.,Bproviders,Bpatients,Bpayers)BthroughoutBallB
phasesBofBtheBrevenueBcycle.



CodingBandBCodingBGuidelines:BIdentifyBandBapplyBwhat?B-BCORRECTBANSWERB-
IdentifyBandBapplyBtheBcorrectBmodifiersBinBHCPCSBandBCPTBcoding.



CodingBandBCodingBGuidelines:BReviewBwhat?B-BCORRECTBANSWERB-
ReviewBmedicalBproceduresBandBcodesBasBdocumentedBbyBprovidersBandBotherBcliniciansBandBqueryBprovi
dersBorBcliniciansBwhenBclarificationBisBneeded.



CodingBandBCodingBGuidelines:BIdentifyBandBapplyBwhatBelse?B-BCORRECTBANSWERB-
HCPCSBandBCPTBcodesBtoBtheBhighestBlevelBofBspecificityBandBinBtheBproperBsequenceBbasedBonBcodingBgui
delinesBandBproviderBdocumentationBinBtheBhealthBrecord.



CodingBandBCodingBGuidelines:BIdentifyBandBapplyBwhatBcodeBset?B-BCORRECTBANSWERB-ICD-10-
CMBcodesBtoBtheBhighestBlevelBofBspecificityBandBinBtheBproperBsequenceBbasedBonBcodingBguidelinesBandB
providerBdocumentationBinBtheBhealthBrecord.



CodingBandBCodingBGuidelines:BAbstractBwhat?B-BCORRECTBANSWERB-
requiredBhealthBinformationBfromBclinicalBdocumentationBbyBapplyingBknowledgeBofBmedicalBterminologyB
andBanatomyBandBphysiology.



CodingBandBCodingBGuidelines:BIdentifyBandBapplyBwhatBotherBkindBofBcode?B-BCORRECTBANSWERB-
EvaluationBandBManagementB(E/M)BcodesBtoBtheBcorrectBlevelBofBspecificityBandBinBtheBproperBsequenceBb
asedBonBkeyBcomponents,BmedicalBdecision-
making,Btime,BcodingBguidelines,BandBproviderBdocumentationBinBtheBhealthBrecord.



WhatBformsBdoByouBcompleteBwhenBitBcomesBtoBidentifyingBstuffBforBbillingBandBreimbursement?B-
BCORRECTBANSWERB-allBareasBofBtheBCMS-1500BclaimBform/837PBform,BbasedBonBtheBtypeBofBpayer.




HowBdoByouBtransmitBclaimsBtoBpayers?B-BCORRECTBANSWERB-
electronicallyB(e.g.,BdirectBentry,BthroughBaBclearinghouse)BorBbyBmail.