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Exam (elaborations)

CBCS Practice Test Study Guide Questions and Answers Top Graded 2025

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A patient's health plan is referred to as the payer of last resort. The patient is covered by which of the following health plans? Medicaid CHAMPA Medicare TRICARE - Correct Ans-Medicaid A provider charged $500 to a claim that had an allowable amount of $400. In which of the following columns should the CBCS apply the non allowed charge? -Reference column (For notations) -Description column -Payment column -Adjustment column of the credits - Correct Ans-Adjustment column of the credits Which of the following statements is correct regarding a deductible? -Coinsurance is a type of deductible -The physician should write off the deductible -The insurance company pays for the deductible -The deductible is the patient's responsibility - Correct Ans-The deductible is the patient's responsibility Which of the following color formats allows optical scanning of the CMS-1500 claim form? -Red -Blue -Green -black - Correct Ans-red Ambulatory surgery centers, home health and hospice organizations use the ______. -CMS-1500 claim form -UB-04 claim form -Advance Beneficiary notice -First report of injury form - Correct Ans-UB-04 Claims that are submitted without an NPI number will delay payment to the provider because ______. -The number is the patient' id number -The number is needed to identify the provider -Is is used as a claim number -It is used as a pre authorization number - Correct Ans-The number is needed to identify the provider Which of the following terms describes when a plan pays 70% of the allowed amount and the patient pays 30%? -Coinsurance -Deductible -Premium -copayment - Correct Ans-coinsurance Which of the following indicates a claim should be submitted on paper instead of electronically? -The software claims review process indicates the claim is not complete -The claim needs authorization -The claim requires an attachment -The practice management software is non functional. - Correct Ans-the claim requires an attachment On a remittance advice form, which of the following is responsible for writing off the difference between the amount billed and the amount allowed by the agreement? -Provider -Insurance company -Patient -Third party payer - Correct Ans-provider A physician is contracted with an insurance company to accept the amount. The insurance company allows $80 of a $120 billed amount, and $50 of the deductible has not been met. How much should the physician write off the patient's account? -$40 -$15 -$0 -$50 - Correct Ans-$40 The unlisted codes can be found in which of the following locations in the CPT manual? -Appendix L -Guidelines prior to each section -End of each body system -Table of contents - Correct Ans-Guidelines prior to each section Which of the following blocks should the billing and coding specialist complete the CMS 1500 claims form for procedure, services or supplies? -Block 12 -Block 2 -Block 24D -Block 24J - Correct Ans-Block 24D -Block 12 (patient's authorization block -Block 2 ( patient's name) -Block 24J ( for the rendering provider) Which of the following blocks requires the patient's authorization to release medical information to process a claim? Block 12 Block 13 Block 27 Block 31 - Correct Ans-Block 12 - Block 13 patient authorization for benefits required for third party payer - Block 27 accepting assignment of benefits - Block 31 (treating physician) Which of the following steps would be part of a physician's practice compliance program? -HIPAA compliance audit -Physician recruitment -Internal monitoring and auditing -Notice of privacy practice - Correct Ans-Internal monitoring and auditing

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Uploaded on
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Number of pages
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Written in
2024/2025
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CBCS practice test



CBCS Practice Test Study Guide Questions
and Answers Top Graded 2025
A patient's health plan is referred to as the payer of last resort. The patient is covered by
which of the following health plans?
Medicaid
CHAMPA
Medicare
TRICARE - Correct Ans-Medicaid


A provider charged $500 to a claim that had an allowable amount of $400. In which of
the following columns should the CBCS apply the non allowed charge?
-Reference column (For notations)
-Description column
-Payment column
-Adjustment column of the credits - Correct Ans-Adjustment column of the credits


Which of the following statements is correct regarding a deductible?
-Coinsurance is a type of deductible
-The physician should write off the deductible
-The insurance company pays for the deductible
-The deductible is the patient's responsibility - Correct Ans-The deductible is the
patient's responsibility


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

1|Page

,CBCS practice test


-Blue
-Green
-black - Correct Ans-red


Ambulatory surgery centers, home health and hospice organizations use the ______.
-CMS-1500 claim form
-UB-04 claim form
-Advance Beneficiary notice
-First report of injury form - Correct Ans-UB-04


Claims that are submitted without an NPI number will delay payment to the provider
because ______.
-The number is the patient' id number
-The number is needed to identify the provider
-Is is used as a claim number
-It is used as a pre authorization number - Correct Ans-The number is needed to identify
the provider


Which of the following terms describes when a plan pays 70% of the allowed amount
and the patient pays 30%?
-Coinsurance
-Deductible
-Premium
-copayment - Correct Ans-coinsurance


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

2|Page

,CBCS practice test


-The software claims review process indicates the claim is not complete
-The claim needs authorization
-The claim requires an attachment
-The practice management software is non functional. - Correct Ans-the claim requires
an attachment


On a remittance advice form, which of the following is responsible for writing off the
difference between the amount billed and the amount allowed by the agreement?
-Provider
-Insurance company
-Patient
-Third party payer - Correct Ans-provider


A physician is contracted with an insurance company to accept the amount. The
insurance company allows $80 of a $120 billed amount, and $50 of the deductible has
not been met. How much should the physician write off the patient's account?
-$40
-$15
-$0
-$50 - Correct Ans-$40


The unlisted codes can be found in which of the following locations in the CPT manual?
-Appendix L
-Guidelines prior to each section
-End of each body system
-Table of contents - Correct Ans-Guidelines prior to each section



3|Page

, CBCS practice test


Which of the following blocks should the billing and coding specialist complete the CMS
1500 claims form for procedure, services or supplies?
-Block 12
-Block 2
-Block 24D
-Block 24J - Correct Ans-Block 24D
-Block 12 (patient's authorization block
-Block 2 ( patient's name)
-Block 24J ( for the rendering provider)


Which of the following blocks requires the patient's authorization to release medical
information to process a claim?
Block 12
Block 13
Block 27
Block 31 - Correct Ans-Block 12
- Block 13 patient authorization for benefits required for third party payer
- Block 27 accepting assignment of benefits
- Block 31 (treating physician)


Which of the following steps would be part of a physician's practice compliance
program?
-HIPAA compliance audit
-Physician recruitment
-Internal monitoring and auditing
-Notice of privacy practice - Correct Ans-Internal monitoring and auditing


4|Page

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