AMCA BILLING & CODING TEST 2026 FINAL
PAPER COMPLETE QUESTIONS AND ANSWERS
FULL SOLUTION
◉ Why is a superbill/encounter form an important document in the
office?
a. It is used when considering purchasing medical billing software
b. It has information needed for vendors
c. It ensures the correct spelling of the patient's name
d. It ensures the correct patient data information and procedure
codes.
Answer: D
◉ Which of the following facilities does not use CMS-1500 forms?
a. ASC (Ambulatory Surgery Center)
b. Nursing Home
c. Acute care
d. Dialysis clinic.
Answer: D
,◉ Physicians usually submit claims for patients and receive
payments directly for the payers. The policy holder authorizes this
by signing and dating a:
a. Accept assignment
b. Schedule of benefits
c. Assignment of benefits
d. Encounter form.
Answer: C
◉ Under the HIPAA Privacy Rule, providers do not need specific
authorization in order to release a patients PHI for TPO purposes.
What does TPO stand for?
a. Treatment, patient protection, operations
b. Treatment, payment and health care operations
c. Type of payment, patient and observation
d. Type of insurance, payment, and health care operations.
Answer: B
◉ If both parents cover dependents on their plan, the child's
primary insurance is usually determined by the birthday rule. What
is meant by the birthday rule?
a. If the mother is older than the father than she is primary
b. The parent whose birthday is earlier in the calendar year is the
primary
, c. The father is usually older than the mother so he is the primary
d. The parent whose birthday is closest to the child's birthday is the
primary.
Answer: B
◉ There are three participants in the medical insurance
relationship: the first party, the second party and the third party.
Who is referred to as the second party?
a. Physician
b. Secondary insurance
c. Patient
d. Insurance company.
Answer: C
◉ Co-insurance is calculated based on:
Select One:
a. A capitation rate
b. The numbers of policy holders in a plan
c. A fixed charge for each visit
d. A percentage of a charge.
Answer: D
PAPER COMPLETE QUESTIONS AND ANSWERS
FULL SOLUTION
◉ Why is a superbill/encounter form an important document in the
office?
a. It is used when considering purchasing medical billing software
b. It has information needed for vendors
c. It ensures the correct spelling of the patient's name
d. It ensures the correct patient data information and procedure
codes.
Answer: D
◉ Which of the following facilities does not use CMS-1500 forms?
a. ASC (Ambulatory Surgery Center)
b. Nursing Home
c. Acute care
d. Dialysis clinic.
Answer: D
,◉ Physicians usually submit claims for patients and receive
payments directly for the payers. The policy holder authorizes this
by signing and dating a:
a. Accept assignment
b. Schedule of benefits
c. Assignment of benefits
d. Encounter form.
Answer: C
◉ Under the HIPAA Privacy Rule, providers do not need specific
authorization in order to release a patients PHI for TPO purposes.
What does TPO stand for?
a. Treatment, patient protection, operations
b. Treatment, payment and health care operations
c. Type of payment, patient and observation
d. Type of insurance, payment, and health care operations.
Answer: B
◉ If both parents cover dependents on their plan, the child's
primary insurance is usually determined by the birthday rule. What
is meant by the birthday rule?
a. If the mother is older than the father than she is primary
b. The parent whose birthday is earlier in the calendar year is the
primary
, c. The father is usually older than the mother so he is the primary
d. The parent whose birthday is closest to the child's birthday is the
primary.
Answer: B
◉ There are three participants in the medical insurance
relationship: the first party, the second party and the third party.
Who is referred to as the second party?
a. Physician
b. Secondary insurance
c. Patient
d. Insurance company.
Answer: C
◉ Co-insurance is calculated based on:
Select One:
a. A capitation rate
b. The numbers of policy holders in a plan
c. A fixed charge for each visit
d. A percentage of a charge.
Answer: D
