CPB Chapter 8 questions with 100% correct answers 2024/2025

CPB Chapter 8Facility charges are reported on which claim form? A. UB-05 claim form B. CMS-1500 claim form C. UB-04 claim form D. Either CMS-1500 or UB-04 claim form - correct answer C. UB-04 claim form Response Feedback: The UB-04 claim form is used to report facility charges to the payer for reimbursement. Which transaction is NOT specified in the 5010 transaction standards? A. Claims B. Eligibility C. Acknowledgement for Healthcare Insurance D. Acknowledgement for Patient Payments - correct answer D. Acknowledgement for Patient Payments Response Feedback: The 5010 transaction standards include Claims (837 Institutional, Professional, Dental, COB [Professional and Institutional] and, NCPDP), Claims Status Inquiry/Response (276/277), Remittance (835), Enrollment (834), Premium Payment (820), Eligibility Inquiry/Response (270/271), Referrals and Prior Authorizations (278), Claims Acknowledgements (277CA), Acknowledgement for Healthcare Insurance (999). CMS-1500 Claim Form revisions undergo: A. one NUCC review prior to approval. B. one CMS review prior to approval. C. one HHS and one CMS review and approval. D. multiple reviews prior to approval and implementation - correct answer D. multiple reviews prior to approval and implementation Response Feedback: The approval process for CMS-1500 Claim Form revisions includes multiple reviews and approvals. Once the updates have been approved by NUCC, the form is submitted to CMS for approval and then awaits public comment through CMS and OMB before receiving final approval and implementation. What regulation requires claims to be sent electronically unless certain circumstances are met? A. Administrative Simplification Compliance Act (ASCA) B. False Claims Act (FCA) C. Electronic Claims Act (ECA) D. Health Information Technology for Economic and Clinical Health Act (HITECH) Response Feedback: It is important to understand that the Administrative Simplification Compliance Act (ASCA) requires that claims be sent electronically unless certain exceptions are met. - correct answer A. Administrative Simplification Compliance Act (ASCA) Response Feedback: It is important to understand that the Administrative Simplification Compliance Act (ASCA) requires that claims be sent electronically unless certain exceptions are met. Item 14 Qualifier is used to indicate what information?