CBCS practice test || ALL QUESTIONS ANSWERED;
CORECTLY TO SCORE A+
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 answers 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 answers 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 answers 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 answers 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 answers 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 answers 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 answers 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 answers 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 answers 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 answers $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 answers 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 answers 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 answers 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 answers Internal monitoring and auditing
Behavior plays an important part of being a team player in a medical practice. Which of the
following is an appropriate action for the CBCS to take?
-Reprimanding another staff member during a team meeting for displaying a bad attitude
toward a patient
-Looking in the medical record of a friend who receives services at the office
-Communicating with the front desk staff during a team meeting about missing information
in patient files
-Questioning the nurse about the provider documentation in the medical record correct
answers Communicating with the front desk staff during a team meeting about missing
information in patient files
Which of the following acts applies to the administrative simplification guideline?
-HIPAA
-Deficit reduction act of 2005
-The patient protection and affordable care act 2009
-National correct coding initiative of 1995 correct answers HIPAA
Which of the following is an example of a violation of an adult patient's confidentiality?
-While reviewing a claim, the CBCS reads the diagnosis before realizing that the patient is a
neighbor
-A CBCS queries the physician about a diagnosis in a patient's medical record
-The physician uses his home phone to discuss patient care with the nursing staff
-Patient information was disclosed to the patient's parents without consent correct answers
Patient information was disclosed to the patient's parents without consent
Which of the following is the purpose of running an aging report each month?
-If indicates the balances the patients owe the provider
-It indicates which patients have upcoming or missed appointment
-It indicates which claims are outstanding
-It indicates what the insurance company has paid for the provider's services to a patient.
correct answers It indicates which claims are outstanding
Which of the following describes the status of a claim that does not include the required
preauthorization for a service?
-Delinquent (overdue)
-Denied
-Suspended
-Adjudicated (claim still being processed) correct answers Denied
-Delinquent (overdue)
-Adjudicated (claim still being processed)
Which of the following actions should the CBCS take to prevent fraud and abuse in the
medical office?
, -Serviced procedure preauthorization
-Internal monitoring and auditing
-Utilization review
-Correct coding initiative correct answers Internal monitoring and auditing
In an outpatient setting, which of the following forms is used as a financial report of all
services provided to patients?
-Encounter form
-Patient account record
-CMS-1500 claim form
-Accounts receivable journal correct answers Patient account record (patient ledger, all
transactions between patient and the practice)
-Accounts receivable journal (Day sheet = chronological summary of all transaction on a
specific day)
Patient charges that have not been paid will appear in which of the following?
-Accounts receivable
-Accounts payable
-Tracer
-Rejected claim correct answers Accounts receivable
Which of the following is considered the final determination of the issues involving
settlement of an insurance claim?
-Processing
-Translation
-Adjudication
-Transmission correct answers Adjudication (process of putting a claim through a series of
edits for final determination)
-Processing ( handling a claim from the first encounter to claim submission)
-Translation (claim is send from the host system to the clearing house)
-Transmission (how the claim was sent)
Which of the following information should the CBCS input into block 33a on the CMS-1500
claim form
-Provider social security number (no Social security number on CMS1500)
-Federal tax id number (entered in block 25)
-Patient id number (on block 1a)
-National provider identification number correct answers National provider identification
number
A prospective billing account audit prevents fraud by reviewing and comparing a completed
claim form with which of the following documents?
-A billing worksheet from the patient account
-A superbill
-A day sheet
-Am accounts receivable report of the patient account correct answers A billing worksheet
from the patient account
When a patient has a condition that is both acute and chronic, how should it be reported?
-Code only the acute code
CORECTLY TO SCORE A+
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 answers 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 answers 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 answers 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 answers 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 answers 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 answers 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 answers 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 answers 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 answers 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 answers $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 answers 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 answers 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 answers 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 answers Internal monitoring and auditing
Behavior plays an important part of being a team player in a medical practice. Which of the
following is an appropriate action for the CBCS to take?
-Reprimanding another staff member during a team meeting for displaying a bad attitude
toward a patient
-Looking in the medical record of a friend who receives services at the office
-Communicating with the front desk staff during a team meeting about missing information
in patient files
-Questioning the nurse about the provider documentation in the medical record correct
answers Communicating with the front desk staff during a team meeting about missing
information in patient files
Which of the following acts applies to the administrative simplification guideline?
-HIPAA
-Deficit reduction act of 2005
-The patient protection and affordable care act 2009
-National correct coding initiative of 1995 correct answers HIPAA
Which of the following is an example of a violation of an adult patient's confidentiality?
-While reviewing a claim, the CBCS reads the diagnosis before realizing that the patient is a
neighbor
-A CBCS queries the physician about a diagnosis in a patient's medical record
-The physician uses his home phone to discuss patient care with the nursing staff
-Patient information was disclosed to the patient's parents without consent correct answers
Patient information was disclosed to the patient's parents without consent
Which of the following is the purpose of running an aging report each month?
-If indicates the balances the patients owe the provider
-It indicates which patients have upcoming or missed appointment
-It indicates which claims are outstanding
-It indicates what the insurance company has paid for the provider's services to a patient.
correct answers It indicates which claims are outstanding
Which of the following describes the status of a claim that does not include the required
preauthorization for a service?
-Delinquent (overdue)
-Denied
-Suspended
-Adjudicated (claim still being processed) correct answers Denied
-Delinquent (overdue)
-Adjudicated (claim still being processed)
Which of the following actions should the CBCS take to prevent fraud and abuse in the
medical office?
, -Serviced procedure preauthorization
-Internal monitoring and auditing
-Utilization review
-Correct coding initiative correct answers Internal monitoring and auditing
In an outpatient setting, which of the following forms is used as a financial report of all
services provided to patients?
-Encounter form
-Patient account record
-CMS-1500 claim form
-Accounts receivable journal correct answers Patient account record (patient ledger, all
transactions between patient and the practice)
-Accounts receivable journal (Day sheet = chronological summary of all transaction on a
specific day)
Patient charges that have not been paid will appear in which of the following?
-Accounts receivable
-Accounts payable
-Tracer
-Rejected claim correct answers Accounts receivable
Which of the following is considered the final determination of the issues involving
settlement of an insurance claim?
-Processing
-Translation
-Adjudication
-Transmission correct answers Adjudication (process of putting a claim through a series of
edits for final determination)
-Processing ( handling a claim from the first encounter to claim submission)
-Translation (claim is send from the host system to the clearing house)
-Transmission (how the claim was sent)
Which of the following information should the CBCS input into block 33a on the CMS-1500
claim form
-Provider social security number (no Social security number on CMS1500)
-Federal tax id number (entered in block 25)
-Patient id number (on block 1a)
-National provider identification number correct answers National provider identification
number
A prospective billing account audit prevents fraud by reviewing and comparing a completed
claim form with which of the following documents?
-A billing worksheet from the patient account
-A superbill
-A day sheet
-Am accounts receivable report of the patient account correct answers A billing worksheet
from the patient account
When a patient has a condition that is both acute and chronic, how should it be reported?
-Code only the acute code
