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CPB Final Exam Complete Solution 2023 
A practice agrees to pay $250,000.00 to settle a lawsuit alleging that the practice used x-rays of one 
patient to justify services on multiple other patients' claims. The office manager brought the civil suit. 
What type of case is this? Ans- Qui Tam 
In which of the following circumstances may PHI not be disclosed without the patient's authorization or 
permission? Ans- An office receives a call from the patient's husband asking for information abou...
- Exam (elaborations)
- • 16 pages's •
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CPB•CPB
CPB Final Exam 2022 
EPO Ans- ...provides benefits to subscribers who are required to receive services from network providers 
IDS Ans- ...organizations of affiliated providers sites that offer joint healthcare services to subscribers 
HMO Ans- ...providers comprehensive healthcare services to voluntarily enrolled members on a prepaid 
basis 
POS Ans- ...patients can use the managed care panel of providers (paying discounted healthcare cost) or 
self-refer to out-of-network providers (and pay ...
- Exam (elaborations)
- • 6 pages's •
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CPB•CPB
WHO IS COVERED BY CHAMPVA? 
 
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES 
B) ACTIVE DUTY MILITARY AND THEIR FAMILIES 
C) RETIRED MILITARY AND THEIR FAMILIES 
D) ACTIVE DUTY MILITARY OVER THE AGE OF 65 -ANSWERS A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES 
 
RATIONALE: THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS (CHAMPVA) COVERS VETERANS WHO ARE PERMANENTLY AND TOTALLY DISABLED DUE TO A SERVICE-RELATED DISABILIT...
- Exam (elaborations)
- • 16 pages's •
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CPB•CPB
CPB PRACTICE EXAM QUESTIONS AND ANSWERS, GRADED A+ 
 
WHO IS COVERED BY CHAMPVA? 
 
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES 
B) ACTIVE DUTY MILITARY AND THEIR FAMILIES 
C) RETIRED MILITARY AND THEIR FAMILIES 
D) ACTIVE DUTY MILITARY OVER THE AGE OF 65 
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES 
 
RATIONALE: THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS (CHAMPVA) COVERS VETERANS WHO ARE PERMANENTLY AND TOTALLY...
- Exam (elaborations)
- • 15 pages's •
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CPB•CPB
CPB PRACTICE EXAM QUESTIONS AND ANSWERS, GRADED A+ 
 
WHO IS COVERED BY CHAMPVA? 
 
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES 
B) ACTIVE DUTY MILITARY AND THEIR FAMILIES 
C) RETIRED MILITARY AND THEIR FAMILIES 
D) ACTIVE DUTY MILITARY OVER THE AGE OF 65 
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES 
 
RATIONALE: THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS (CHAMPVA) COVERS VETERANS WHO ARE PERMANENTLY AND TOTALLY...
- Exam (elaborations)
- • 15 pages's •
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CPB•CPB
CPB PRACTICE EXAM QUESTIONS AND ANSWERS, GRADED A+ 
 
WHO IS COVERED BY CHAMPVA? 
 
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES 
B) ACTIVE DUTY MILITARY AND THEIR FAMILIES 
C) RETIRED MILITARY AND THEIR FAMILIES 
D) ACTIVE DUTY MILITARY OVER THE AGE OF 65 
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES 
 
RATIONALE: THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS (CHAMPVA) COVERS VETERANS WHO ARE PERMANENTLY AND TOTALLY...
- Exam (elaborations)
- • 15 pages's •
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CPB•CPB
CPB PRACTICE EXAM QUESTIONS AND ANSWERS, GRADED A+ 
 
WHO IS COVERED BY CHAMPVA? 
 
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES 
B) ACTIVE DUTY MILITARY AND THEIR FAMILIES 
C) RETIRED MILITARY AND THEIR FAMILIES 
D) ACTIVE DUTY MILITARY OVER THE AGE OF 65 
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES 
 
RATIONALE: THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS (CHAMPVA) COVERS VETERANS WHO ARE PERMANENTLY AND TOTALLY...
- Exam (elaborations)
- • 15 pages's •
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CPB•CPB
what is not specified in the 5010 transaction standards 
acknowledgement for patient payments 
 
 
NUCC stands for 
National unified claim committe 
 
 
 
 
 
00:52 
00:54 
ASCA Administrative simplification compliance act 
requires claims to be sent electronically 
 
 
item 14 qualifier on a CMS form 
indicates if the date is a symptom or menstrual cycle 
 
 
Aentas guildlines for filing a level 1 or 2 appeal 
within 60 calendar days of previous decision 
 
 
Liability Issue 
commercial insuran...
- Exam (elaborations)
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CPB•CPB
Joe and Mary are a married couple and both carry insurance from their employers. Joe was born on February 23, 1977 and Mary was born on April 4, 1974. Using the birthday rule, who carries the primary insurance for their children for billing? 
 
A. Joe, because he is the male head of the household. 
B. Mary, because her date of birth is the 4th and Joe's date of birth is the 23rd. 
C. Mary, because her birth year is before Joe's birth year. 
D. Joe, because his birth month and day are before Ma...
- Exam (elaborations)
- • 56 pages's •
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CPB•CPB
EPO 
...provides benefits to subscribers who are required to receive services from network providers 
 
 
IDS 
...organizations of affiliated providers sites that offer joint healthcare services to subscribers 
 
 
 
 
 
 
00:41 
00:54 
HMO 
...providers comprehensive healthcare services to voluntarily enrolled members on a prepaid basis 
 
 
POS 
...patients can use the managed care panel of providers (paying discounted healthcare cost) or self-refer to out-of-network providers (and pay higher ...
- Exam (elaborations)
- • 5 pages's •
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CPB•CPB
WHO IS COVERED BY CHAMPVA? 
 
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES 
B) ACTIVE DUTY MILITARY AND THEIR FAMILIES 
C) RETIRED MILITARY AND THEIR FAMILIES 
D) ACTIVE DUTY MILITARY OVER THE AGE OF 65 
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES 
 
RATIONALE: THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS (CHAMPVA) COVERS VETERANS WHO ARE PERMANENTLY AND TOTALLY DISABLED DUE TO A SERVICE-RELATED DISABILITY AND THEI...
- Exam (elaborations)
- • 16 pages's •
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CPB•CPB
Abuse 
An action that results in unnecessary costs to a federal healthcare program, directly or indirectly. 
 
 
Anti-kickback 
Knowingly and willfully offering or accepting rewards or remuneration for services that are billable to a federal healthcare plan. 
 
 
 
 
 
 
00:06 
01:14 
Benefiiciary 
An individual that is eligible for Medicare or Medicaid benefits based on the CMS guidelines. 
 
 
Conditions of Participation (CoP) 
Conditions that healthcare organizations must meet in order to par...
- Exam (elaborations)
- • 7 pages's •
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CPB•CPB
CPB PRACTICE EXAM QUESTIONS AND ANSWERS NEW 2022 EXAM UPDATE GRADED A SOLUTION
- Exam (elaborations)
- • 12 pages's •
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CPB•CPB