NHA CBCS Certification Study Guide Questions 2025. (Correct Answers)

NHA CBCS Certification Study Guide
Questions 2025. (Correct Answers)




abstracting - correct answer the extraction of specific data from a medical record, often for use in an external
w w w w w w w w w w w w w w w w w w w




database, such as a cancer registry
w w w w w




abuse - correct answer practices that directly or indirectly result in unnecessary costs to the Medicare
w w w w w w w w w w w w w w w w




program



account number - correct answer number that identifies specific episode of care, date of service, or patient
w w w w w w w w w w w w w w w w




accounts receivable department - correct answer Department that keeps track of what third-party payers
w w w w w w w w w w w w w w




the provider is waiting to hear from and what patients are due to make a payment.
w w w w w w w w w w w w w w w




activity/status date - correct answer Indicates the most recent activity of an item.
w w w w w w w w w w w w




actual charge - correct answer the amount the provider charges for the health care service
w w w w w w w w w w w w w w




Administration Simplification Compliance Act (ASCA) - correct answer specifically prohibits any payment by
w w w w w w w w w w w w w




Medicare for services or medically necessary supplies that are not submitted electronically
w w w w w w w w w w w




administrative services only (ASO) contract - correct answer Contract between employers and private
w w w w w w w w w w w w w




insurers under which employers fund the plans themselves, and the private insurers administer the plans for
w w w w w w w w w w w w w w w w




the employers.
w

, Advance Beneficiary Notice of Noncoverage (ABN) - correct answer Form provided if a provider believes that
w w w w w w w w w w w w w w w w




a service may be declined because Medicare might consider it unnecessary.
w w w w w w w w w w




aging report - correct answer Measures the outstanding balances in each account.
w w w w w w w w w w w




allowable charge - correct answer The amount an insurer will accept as full payment, minus applicable cost
w w w w w w w w w w w w w w w w w




sharing.



APC grouper - correct answer Helps coders determine the appropriate ambulatory payment classification
w w w w w w w w w w w w w




(APC) for an outpatient encounter.
w w w w




assignment of benefits - correct answer Contract in which the provider directly bills the payer and accepts the
w w w w w w w w w w w w w w w w w




allowable charge.
w w




auditing - correct answer review of claims for accuracy and completeness
w w w w w w w w w w




authorization - correct answer Permission granted by the patient or the patient's representative to release
w w w w w w w w w w w w w w w




information for reasons other than treatment, payment, or health care operations.
w w w w w w w w w w




balance billing - correct answer Billing patients for charges in excess of the Medicare fee schedule.
w w w w w w w w w w w w w w w




batch - correct answer a group of submitted claims
w w w w w w w w




Blue Cross and Blue Shield plan - correct answer The first prepaid plan in the U.S. that offers health insurance
w w w w w w w w w w w w w w w w w w w w




to individuals, small businesses, seniors, and large employer groups.
w w w w w w w w




business associate (BA) - correct answer Individuals, groups, or organizations, who are not members of a
w w w w w w w w w w w w w w w w




covered entity's workforce, that perform functions or activities on behalf of or for a covered entity.
w w w w w w w w w w w w w w w




capitation - correct answer the fixed amount a provider receives
w w w w w w w w w