CBCS EXAM 2024/2025 WITH 100% ACCURATE
SOLUTIONS
A patient's health plan is referred to as the payer of last resort. The
patient is covered by which of the following health plans?
Medicaid
CHAMPA
Medicare
TRICARE - Precise Answer ✔✔Medicaid
A provider charged $500 to a claim that had an allowable amount of
$400. In which of the following columns should the CBCS apply the non
allowed charge?
-Reference column (For notations)
-Description column
-Payment column
-Adjustment column of the credits - Precise Answer ✔✔Adjustment
column of the credits
Which of the following statements is correct regarding a deductible?
-Coinsurance is a type of deductible
-The physician should write off the deductible
-The insurance company pays for the deductible
,-The deductible is the patient's responsibility - Precise Answer ✔✔The
deductible is the patient's responsibility
Which of the following color formats allows optical scanning of the
CMS-1500 claim form?
-Red
-Blue
-Green
-black - Precise Answer ✔✔red
Ambulatory surgery centers, home health and hospice organizations use
the ______.
-CMS-1500 claim form
-UB-04 claim form
-Advance Beneficiary notice
-First report of injury form - Precise Answer ✔✔UB-04
Claims that are submitted without an NPI number will delay payment to
the provider because ______.
-The number is the patient' id number
-The number is needed to identify the provider
-Is is used as a claim number
-It is used as a pre authorization number - Precise Answer ✔✔The
number is needed to identify the provider
,Which of the following terms describes when a plan pays 70% of the
allowed amount and the patient pays 30%?
-Coinsurance
-Deductible
-Premium
-copayment - Precise Answer ✔✔coinsurance
Which of the following indicates a claim should be submitted on paper
instead of electronically?
-The software claims review process indicates the claim is not complete
-The claim needs authorization
-The claim requires an attachment
-The practice management software is non functional. - Precise Answer
✔✔the claim requires an attachment
On a remittance advice form, which of the following is responsible for
writing off the difference between the amount billed and the amount
allowed by the agreement?
-Provider
-Insurance company
-Patient
-Third party payer - Precise Answer ✔✔provider
, A physician is contracted with an insurance company to accept the
amount. The insurance company allows $80 of a $120 billed amount,
and $50 of the deductible has not been met. How much should the
physician write off the patient's account?
-$40
-$15
-$0
-$50 - Precise Answer ✔✔$40
The unlisted codes can be found in which of the following locations in
the CPT manual?
-Appendix L
-Guidelines prior to each section
-End of each body system
-Table of contents - Precise Answer ✔✔Guidelines prior to each section
Which of the following blocks should the billing and coding specialist
complete the CMS 1500 claims form for procedure, services or supplies?
-Block 12
-Block 2
-Block 24D
-Block 24J - Precise Answer ✔✔Block 24D
-Block 12 (patient's authorization block
-Block 2 ( patient's name)
-Block 24J ( for the rendering provider)
SOLUTIONS
A patient's health plan is referred to as the payer of last resort. The
patient is covered by which of the following health plans?
Medicaid
CHAMPA
Medicare
TRICARE - Precise Answer ✔✔Medicaid
A provider charged $500 to a claim that had an allowable amount of
$400. In which of the following columns should the CBCS apply the non
allowed charge?
-Reference column (For notations)
-Description column
-Payment column
-Adjustment column of the credits - Precise Answer ✔✔Adjustment
column of the credits
Which of the following statements is correct regarding a deductible?
-Coinsurance is a type of deductible
-The physician should write off the deductible
-The insurance company pays for the deductible
,-The deductible is the patient's responsibility - Precise Answer ✔✔The
deductible is the patient's responsibility
Which of the following color formats allows optical scanning of the
CMS-1500 claim form?
-Red
-Blue
-Green
-black - Precise Answer ✔✔red
Ambulatory surgery centers, home health and hospice organizations use
the ______.
-CMS-1500 claim form
-UB-04 claim form
-Advance Beneficiary notice
-First report of injury form - Precise Answer ✔✔UB-04
Claims that are submitted without an NPI number will delay payment to
the provider because ______.
-The number is the patient' id number
-The number is needed to identify the provider
-Is is used as a claim number
-It is used as a pre authorization number - Precise Answer ✔✔The
number is needed to identify the provider
,Which of the following terms describes when a plan pays 70% of the
allowed amount and the patient pays 30%?
-Coinsurance
-Deductible
-Premium
-copayment - Precise Answer ✔✔coinsurance
Which of the following indicates a claim should be submitted on paper
instead of electronically?
-The software claims review process indicates the claim is not complete
-The claim needs authorization
-The claim requires an attachment
-The practice management software is non functional. - Precise Answer
✔✔the claim requires an attachment
On a remittance advice form, which of the following is responsible for
writing off the difference between the amount billed and the amount
allowed by the agreement?
-Provider
-Insurance company
-Patient
-Third party payer - Precise Answer ✔✔provider
, A physician is contracted with an insurance company to accept the
amount. The insurance company allows $80 of a $120 billed amount,
and $50 of the deductible has not been met. How much should the
physician write off the patient's account?
-$40
-$15
-$0
-$50 - Precise Answer ✔✔$40
The unlisted codes can be found in which of the following locations in
the CPT manual?
-Appendix L
-Guidelines prior to each section
-End of each body system
-Table of contents - Precise Answer ✔✔Guidelines prior to each section
Which of the following blocks should the billing and coding specialist
complete the CMS 1500 claims form for procedure, services or supplies?
-Block 12
-Block 2
-Block 24D
-Block 24J - Precise Answer ✔✔Block 24D
-Block 12 (patient's authorization block
-Block 2 ( patient's name)
-Block 24J ( for the rendering provider)
