CPB BILLING CODING CERTIFICATION
2026 PAPER QUESTIONS SOLUTIONS
◉ A patient presents to the ER but is admitted for care. What co-pay
is collected based on the insurance card for a participating facility?
Insured name: Beth Jones Eff Date: 1/1/2013 In-network Ded Out-
of-Network Ded
ID# 123456789 Office visit $15.00 N/A
Deductible $2500 ER $75.00 $75
Co-pay as listed Inpatient $100.00 N/A
Preventive N/A N/A
A.$15.00
B.$75.00
C.$100.00
D. Not Applicable
Answer: C.$100.00
Because the patient was admitted, the copay is $100.00.
,◉ The back of the health insurance card typically includes what
information?
A. Primary Care Provider
B. Co-pays
C. Phone or contact information for eligibility
D. Group number
Answer: C. Phone or contact information for eligibility
Phone and contact information for eligibility are located on the back
of the card.
◉ Verification of insurance will allow the practice to know the
amount to collect from the patient at the time of visit. Which of the
following would NOT be true?
A.If the insurance is unable to be verified the patient is offered the
option for self-pay.
B.Verify that patient information is correct and has been correctly
conveyed to the insurance company.
C. The patient should contact the insurance company if they believe
the coverage is in effect.
D. If the coverage is not in effect the patient should NOT be seen
until the coverage can be verified.
, Answer: D. If the coverage is not in effect the patient should NOT be
seen until the coverage can be verified.
The biller should not make a decision of turning a patient away for
lack of insurance. The option of verifying information and making
contact with the insurance company should be tried first, and the
option should be provided to the patient to pay out-of-pocket.
◉ A patient wants her results called to her home and states the
physician is to talk to her husband. What form should be completed
before this is done?
A. Authorization to Disclose Health Information
B. Consent for Payment
C. Consent for Treatment
D. Patient Information Form
Answer: A. Authorization to Disclose Health Information
Section 164.508 of the HIPAA privacy rule states that covered
entities may not use or disclose protected health information
without a valid authorization. The Authorization to Disclose Health
Information lists the names of the individuals to whom the PHI can
be disclosed.
2026 PAPER QUESTIONS SOLUTIONS
◉ A patient presents to the ER but is admitted for care. What co-pay
is collected based on the insurance card for a participating facility?
Insured name: Beth Jones Eff Date: 1/1/2013 In-network Ded Out-
of-Network Ded
ID# 123456789 Office visit $15.00 N/A
Deductible $2500 ER $75.00 $75
Co-pay as listed Inpatient $100.00 N/A
Preventive N/A N/A
A.$15.00
B.$75.00
C.$100.00
D. Not Applicable
Answer: C.$100.00
Because the patient was admitted, the copay is $100.00.
,◉ The back of the health insurance card typically includes what
information?
A. Primary Care Provider
B. Co-pays
C. Phone or contact information for eligibility
D. Group number
Answer: C. Phone or contact information for eligibility
Phone and contact information for eligibility are located on the back
of the card.
◉ Verification of insurance will allow the practice to know the
amount to collect from the patient at the time of visit. Which of the
following would NOT be true?
A.If the insurance is unable to be verified the patient is offered the
option for self-pay.
B.Verify that patient information is correct and has been correctly
conveyed to the insurance company.
C. The patient should contact the insurance company if they believe
the coverage is in effect.
D. If the coverage is not in effect the patient should NOT be seen
until the coverage can be verified.
, Answer: D. If the coverage is not in effect the patient should NOT be
seen until the coverage can be verified.
The biller should not make a decision of turning a patient away for
lack of insurance. The option of verifying information and making
contact with the insurance company should be tried first, and the
option should be provided to the patient to pay out-of-pocket.
◉ A patient wants her results called to her home and states the
physician is to talk to her husband. What form should be completed
before this is done?
A. Authorization to Disclose Health Information
B. Consent for Payment
C. Consent for Treatment
D. Patient Information Form
Answer: A. Authorization to Disclose Health Information
Section 164.508 of the HIPAA privacy rule states that covered
entities may not use or disclose protected health information
without a valid authorization. The Authorization to Disclose Health
Information lists the names of the individuals to whom the PHI can
be disclosed.
