NCCT Insurance and Coding TEST STUDY GUIDE
2026/2027 COMPLETE QUESTIONS WITH CORRECT
DETAILED ANSWERS ||
100% GUARANTEED PASS
<LATEST VERSION>
1. The patient owes $25.00 for the visit. The amount collected for the office
visit is called what? - ANSWER ✔ Copayment
2. The insurance carrier rate is 80% the remaining 20% is called what? -
ANSWER ✔ Coinsurance
3. A third party payer made an error when adjudicating a claim which of the
following should the specialist do? - ANSWER ✔ resubmit the claim with
an attachment explaining the error
4. A claim submitted with all the necessary and accurate information so that it
can be processed and paid is called? - ANSWER ✔ A clean claim
5. A medicare patient presents to an out patient hospital facility for a
hysterectomy. To which medicare plan should be billed? - ANSWER ✔ Part
B
6. The amount of the bill is $100 and this amount must be paid before the
insurance company will pay on the claim. Which of the following is this
called? - ANSWER ✔ Deductible
,7. The patient is sent a statement for an office visit. The total amount of the bill
is $100.00 and this amount must be paid before the insurance company will
pay on the claim. Which of the following is this called? - ANSWER ✔
deductible
8. The provider is paid the same rate per patient whether or not they provide
services and no matter which services were provided. This payment is
known as - ANSWER ✔ capitation.
9. When using the EHR to schedule a patient visit, which of the following
screens should be used to complete the scheduling process? - ANSWER ✔
patient search
10.Which of the following must a patient sign prior to an insurance claim being
processed? - ANSWER ✔ an Authorization to Release Information
11.When there is a professional courtesy awarded to a patient's account the
insurance and coding specialist should post the amount under the -
ANSWER ✔ adjustment column.
12.When a capitation account is applied to the ledger it is also known as a -
ANSWER ✔ monthly prepayment amount.
13.Which of the following forms provides information from the Managed Care
Organization that paid on the claim? - ANSWER ✔ EOB
,14.Which of the following forms should be transmitted to obtain reimbursement
following a physician's office visit for a patient with active Medicaid
coverage? - ANSWER ✔ CMS-1500
15.Which of the following are necessary to complete a CMS 1500 form?
(Select the three (3)correct answers.) - ANSWER ✔ *physician information
*demographic information
*diagnosis and CPT codes
16.Which of the following fees posted to the patient's account is an example of
"usual, customary, and reasonable?" - ANSWER ✔ allowed amount
17.Which of the following reports is used to follow up on outstanding claims to
third party payers? - ANSWER ✔ aging
18.When posting an insurance payment via an EOB, the amount that is
considered contractual is - ANSWER ✔ insurance allowed amount.
19.When patients sign Block 13 of the CMS-1500 claim to instruct the payer to
directly reimburse the provider, it is known as - ANSWER ✔ assignment of
benefits.
20.Which of the following Medicare parts covers inpatient hospital stays? -
ANSWER ✔ Part A
21.Which of the following financial reports produces a quarterly review of any
dollar amount a patient still owes after all insurance carriers claim payments
have been received? - ANSWER ✔ aging
, 22.Which of the following must be verified to process a credit card transaction?
(Select the three (3) correct answers.) - ANSWER ✔ *account number
*security code
*credit card number
23.Which of the following is the percentage the patient pays for covered service
after the deductible has been met?
A. co-insurance
B. co-pay
C. premium
D. allowed amount - ANSWER ✔ A. co-insurance
Co-insurance is the amount the patient is responsible to pay for an allowable
service, after the deductible has been met. Co-pay is to be paid before
services are rendered. The premium is the payment for the actual insurance
coverage. The allowed amount is the discounted rate that is charged for
services rendered by a provider in the insurance company's network.
24.The patient has health insurance that covers 70% of her covered expenses
that she has incurred which qualifies for reimbursement. The patient's
responsibility will be 30%. This type of cost sharing is referred to as
A. co-payment.
B. deductible.
C. covered expenses.
D. coinsurance. - ANSWER ✔ D. coinsurance.
25.Charges billed to the insurance company were for a total of $250.00. The
allowed amount is $150.00 and the patient has a 90/10 plan. Which of the
following is the co-insurance due from the patient?
A. $10.00
B. $15.00
C. $25.00
D. $135.00 - ANSWER ✔ B. $15.00
2026/2027 COMPLETE QUESTIONS WITH CORRECT
DETAILED ANSWERS ||
100% GUARANTEED PASS
<LATEST VERSION>
1. The patient owes $25.00 for the visit. The amount collected for the office
visit is called what? - ANSWER ✔ Copayment
2. The insurance carrier rate is 80% the remaining 20% is called what? -
ANSWER ✔ Coinsurance
3. A third party payer made an error when adjudicating a claim which of the
following should the specialist do? - ANSWER ✔ resubmit the claim with
an attachment explaining the error
4. A claim submitted with all the necessary and accurate information so that it
can be processed and paid is called? - ANSWER ✔ A clean claim
5. A medicare patient presents to an out patient hospital facility for a
hysterectomy. To which medicare plan should be billed? - ANSWER ✔ Part
B
6. The amount of the bill is $100 and this amount must be paid before the
insurance company will pay on the claim. Which of the following is this
called? - ANSWER ✔ Deductible
,7. The patient is sent a statement for an office visit. The total amount of the bill
is $100.00 and this amount must be paid before the insurance company will
pay on the claim. Which of the following is this called? - ANSWER ✔
deductible
8. The provider is paid the same rate per patient whether or not they provide
services and no matter which services were provided. This payment is
known as - ANSWER ✔ capitation.
9. When using the EHR to schedule a patient visit, which of the following
screens should be used to complete the scheduling process? - ANSWER ✔
patient search
10.Which of the following must a patient sign prior to an insurance claim being
processed? - ANSWER ✔ an Authorization to Release Information
11.When there is a professional courtesy awarded to a patient's account the
insurance and coding specialist should post the amount under the -
ANSWER ✔ adjustment column.
12.When a capitation account is applied to the ledger it is also known as a -
ANSWER ✔ monthly prepayment amount.
13.Which of the following forms provides information from the Managed Care
Organization that paid on the claim? - ANSWER ✔ EOB
,14.Which of the following forms should be transmitted to obtain reimbursement
following a physician's office visit for a patient with active Medicaid
coverage? - ANSWER ✔ CMS-1500
15.Which of the following are necessary to complete a CMS 1500 form?
(Select the three (3)correct answers.) - ANSWER ✔ *physician information
*demographic information
*diagnosis and CPT codes
16.Which of the following fees posted to the patient's account is an example of
"usual, customary, and reasonable?" - ANSWER ✔ allowed amount
17.Which of the following reports is used to follow up on outstanding claims to
third party payers? - ANSWER ✔ aging
18.When posting an insurance payment via an EOB, the amount that is
considered contractual is - ANSWER ✔ insurance allowed amount.
19.When patients sign Block 13 of the CMS-1500 claim to instruct the payer to
directly reimburse the provider, it is known as - ANSWER ✔ assignment of
benefits.
20.Which of the following Medicare parts covers inpatient hospital stays? -
ANSWER ✔ Part A
21.Which of the following financial reports produces a quarterly review of any
dollar amount a patient still owes after all insurance carriers claim payments
have been received? - ANSWER ✔ aging
, 22.Which of the following must be verified to process a credit card transaction?
(Select the three (3) correct answers.) - ANSWER ✔ *account number
*security code
*credit card number
23.Which of the following is the percentage the patient pays for covered service
after the deductible has been met?
A. co-insurance
B. co-pay
C. premium
D. allowed amount - ANSWER ✔ A. co-insurance
Co-insurance is the amount the patient is responsible to pay for an allowable
service, after the deductible has been met. Co-pay is to be paid before
services are rendered. The premium is the payment for the actual insurance
coverage. The allowed amount is the discounted rate that is charged for
services rendered by a provider in the insurance company's network.
24.The patient has health insurance that covers 70% of her covered expenses
that she has incurred which qualifies for reimbursement. The patient's
responsibility will be 30%. This type of cost sharing is referred to as
A. co-payment.
B. deductible.
C. covered expenses.
D. coinsurance. - ANSWER ✔ D. coinsurance.
25.Charges billed to the insurance company were for a total of $250.00. The
allowed amount is $150.00 and the patient has a 90/10 plan. Which of the
following is the co-insurance due from the patient?
A. $10.00
B. $15.00
C. $25.00
D. $135.00 - ANSWER ✔ B. $15.00
