NHA CBCS CERTIFICATION WITH
VERIFIED ANSWERS
Which eof ethe efollowing eis econsidered ethe efinal edetermination eof ethe eissues
einvolving esettlement eof ean einsurance eclaim? e- ecorrect eanswers e-Adjudication
A eform ethat econtains echarges, eDOS, eCPT ecodes, eICD ecodes, efees eand
ecopayment einformation eis ecalled ewhich eof ethe efollowing? e- ecorrect eanswers e-
Encounter eform
A epatient ecomes eto ethe ehospital efor ean einpatient eprocedure. eWhich eof ethe
efollowing ehospital estaff emembers eis eresponsible efor ethe einitial epatient
einterview, eobtaining edemographic eand einsurance einformation, eand edocumenting
ethe echief ecomplaint? e- ecorrect eanswers e-Admitting eclerk
Which eof ethe efollowing eprivacy emeasures eensures eprotected ehealth einformation
e(phi)? e- ecorrect eanswers e-Using edata eencryption esoftware eon eoffice
eworkstations
Which eof ethe efollowing eplanes edivides ethe ebody einto eleft eand eright? e- ecorrect
eanswers e-Sagittal
,Which eof ethe efollowing eprovisions eensures ethat ean einsured's ebenefits efrom eall
einsurance ecompanies edo enot eexceed e100% eof eallowable emedical eexpenses?
e- ecorrect eanswers e-Coordination eof ebenefits
Which eof ethe efollowing eactions eshould ebe etaken efirst ewhen ereviewing ea
edelinquent eclaim? e- ecorrect eanswers e-Verify ethe eage eof ethe eaccount
Which eof ethe efollowing eis ethe eadvantage eof eelectronic eclaim esubmission? e-
ecorrect eanswers e-Claims eare eexpedited
Which eof ethe efollowing ecomponents eof ean eexplanation eof ebenefits eexpedites
ethe eprocess eof ea ephone eappeal? e- ecorrect eanswers e-Claim econtrol enumber
The estandard emedical eabbreviation eECG erefers eto ea etest eused eto eassess
ewhich eof ethe efollowing ebody esystems? e- ecorrect eanswers e-Cardiovascular
esystem
Which eof ethe efollowing eactions eby ea ebilling eand ecoding especialist ewould ebe
econsidered efraud? e- ecorrect eanswers e-Billing efor eservices enot eprovided
The e>< esymbol eis eused eto eindicate ea enew eand erevised etest eother ethan
ewhich eof ethe efollowing? e- ecorrect eanswers e-Procedure edescriptors
On ethe eCMS-1500 eclaim eform, eblocks e14 ethrough e33 econtain einformation
eabout ewhich eof ethe efollowing? e- ecorrect eanswers e-The epatient's econdition
eand ethe eprovider's einformation
Which eof ethe efollowing eincludes eprocedures eand ebest epractices efor ecorrect
ecoding? e- ecorrect eanswers e-Coding eCompliance ePlan
When ecompleting ea eCMS-1500 epaper eclaim eform, ewhich eof ethe efollowing eis
ean eacceptable eaction efor ethe ebilling eand ecoding especialist eto etake? e- ecorrect
eanswers e-Use earial esize e10 efont
A eparticipating eblue ecross/blue eshield e(BC/BS) eprovider ereceives ean
eexplanation eof ebenefits efor ea epatient eaccount. eThe echarged eamount ewas
e$100. eBC/BS eallowed e$80 eand eapplied e$40 eto ethe epatient's eannual
edeductible. eBC/BS epaid ethe ebalance eat e80%. eHow emuch eshould ethe epatient
eexpect eto epay? e- ecorrect eanswers e-$48
Which eof ethe efollowing eindicates ea eclaim eshould ebe esubmitted eon epaper
einstead eof eelectronically? e- ecorrect eanswers e-The eclaim erequires ean
eattachment
, According eto eHIPAA estandards, ewhich eof ethe efollowing eidentifies ethe erendering
eprovider eon ethe eCMS-1500 eclaim eform ein eblock e24j? e- ecorrect eanswers e-
NPI
Which eof ethe efollowing eblocks eshould ethe ebilling eand ecoding especialist
ecomplete eon ethe eCMS-1500 eclaim eform eform efor eprocedures, eservices eor
esupplies e(CPT/HCPCS)? e- ecorrect eanswers e-Block e24D
Which eof ethe efollowing eterms edescribes ewhen ea eplan epays e70% eof ethe
eallowed eamount eand ethe epatient epays e30%? e- ecorrect eanswers e-Coinsurance
A eprovider echarged e$500 eto eclaim ethat ehad ean eallowable eamount eof e$400.
eIn ewhich eof ethe efollowing ecolumns eshould ethe ebilling eand ecoding especialist
eapply ethe enon-allowed echarge? e- ecorrect eanswers e-Adjustment ecolumn eof ethe
ecredits
Which eof ethe efollowing eis ea eHIPAA ecompliance eguideline eaffecting eelectronic
ehealth erecords? e- ecorrect eanswers e-The eelectronic etransmission eand ecode
eset estandards erequire eevery eprovider eto euse ethe ehealthcare etransactions
e,code esets eand eidentifiers
Patient: eJane eAustin; eSocial eSecurity e# e555-22-1111; eMedicare eID: e555-33-
2222A; eDOB: e05/22/1945. eClaim einformation eentered: eAustin, eJane; eSocial
eSecurity e#.: e555-22-1111; eMedicare eID eNo.: e555-33-2222A; eDOB: e052245.
eWhich eof ethe efollowing eis ea ereason ethis eclaim ewas erejected? e- ecorrect
eanswers e-The eDOB eis eentered eincorrectly
Why edoes ecorrect eclaim eprocessing erely eon eaccurately ecompleted eencounter
eforms? e- ecorrect eanswers e-They estreamline epatient ebilling eby esummarizing
ethe eservices erendered efor ea egiven edate eof eservice
A epatient's ehealth eplan eis ereferred eto eas ethe e"payer eof elast eresort." eThe
epatient eis ecovered eby ewhich eof ethe efollowing ehealth eplans? e- ecorrect
eanswers e-Medicaid
Which eof ethe efollowing ecolor eformats eis eacceptable eon ethe eCMS-1500 eclaim
eform? e- ecorrect eanswers e-Red
Which eof ethe efollowing eis ean eexample eof ea eviolation eof ean eadult epatient's
econfidentiality? e- ecorrect eanswers e-Patient einformation ewas edisclosed eto ethe
epatient's eparents ewithout econsent.
In ethe eanesthesia esection eof ethe eCPT emanual, ewhich eof ethe efollowing eare
econsidered equalifying ecircumstances? e- ecorrect eanswers e-Add-on ecodes
VERIFIED ANSWERS
Which eof ethe efollowing eis econsidered ethe efinal edetermination eof ethe eissues
einvolving esettlement eof ean einsurance eclaim? e- ecorrect eanswers e-Adjudication
A eform ethat econtains echarges, eDOS, eCPT ecodes, eICD ecodes, efees eand
ecopayment einformation eis ecalled ewhich eof ethe efollowing? e- ecorrect eanswers e-
Encounter eform
A epatient ecomes eto ethe ehospital efor ean einpatient eprocedure. eWhich eof ethe
efollowing ehospital estaff emembers eis eresponsible efor ethe einitial epatient
einterview, eobtaining edemographic eand einsurance einformation, eand edocumenting
ethe echief ecomplaint? e- ecorrect eanswers e-Admitting eclerk
Which eof ethe efollowing eprivacy emeasures eensures eprotected ehealth einformation
e(phi)? e- ecorrect eanswers e-Using edata eencryption esoftware eon eoffice
eworkstations
Which eof ethe efollowing eplanes edivides ethe ebody einto eleft eand eright? e- ecorrect
eanswers e-Sagittal
,Which eof ethe efollowing eprovisions eensures ethat ean einsured's ebenefits efrom eall
einsurance ecompanies edo enot eexceed e100% eof eallowable emedical eexpenses?
e- ecorrect eanswers e-Coordination eof ebenefits
Which eof ethe efollowing eactions eshould ebe etaken efirst ewhen ereviewing ea
edelinquent eclaim? e- ecorrect eanswers e-Verify ethe eage eof ethe eaccount
Which eof ethe efollowing eis ethe eadvantage eof eelectronic eclaim esubmission? e-
ecorrect eanswers e-Claims eare eexpedited
Which eof ethe efollowing ecomponents eof ean eexplanation eof ebenefits eexpedites
ethe eprocess eof ea ephone eappeal? e- ecorrect eanswers e-Claim econtrol enumber
The estandard emedical eabbreviation eECG erefers eto ea etest eused eto eassess
ewhich eof ethe efollowing ebody esystems? e- ecorrect eanswers e-Cardiovascular
esystem
Which eof ethe efollowing eactions eby ea ebilling eand ecoding especialist ewould ebe
econsidered efraud? e- ecorrect eanswers e-Billing efor eservices enot eprovided
The e>< esymbol eis eused eto eindicate ea enew eand erevised etest eother ethan
ewhich eof ethe efollowing? e- ecorrect eanswers e-Procedure edescriptors
On ethe eCMS-1500 eclaim eform, eblocks e14 ethrough e33 econtain einformation
eabout ewhich eof ethe efollowing? e- ecorrect eanswers e-The epatient's econdition
eand ethe eprovider's einformation
Which eof ethe efollowing eincludes eprocedures eand ebest epractices efor ecorrect
ecoding? e- ecorrect eanswers e-Coding eCompliance ePlan
When ecompleting ea eCMS-1500 epaper eclaim eform, ewhich eof ethe efollowing eis
ean eacceptable eaction efor ethe ebilling eand ecoding especialist eto etake? e- ecorrect
eanswers e-Use earial esize e10 efont
A eparticipating eblue ecross/blue eshield e(BC/BS) eprovider ereceives ean
eexplanation eof ebenefits efor ea epatient eaccount. eThe echarged eamount ewas
e$100. eBC/BS eallowed e$80 eand eapplied e$40 eto ethe epatient's eannual
edeductible. eBC/BS epaid ethe ebalance eat e80%. eHow emuch eshould ethe epatient
eexpect eto epay? e- ecorrect eanswers e-$48
Which eof ethe efollowing eindicates ea eclaim eshould ebe esubmitted eon epaper
einstead eof eelectronically? e- ecorrect eanswers e-The eclaim erequires ean
eattachment
, According eto eHIPAA estandards, ewhich eof ethe efollowing eidentifies ethe erendering
eprovider eon ethe eCMS-1500 eclaim eform ein eblock e24j? e- ecorrect eanswers e-
NPI
Which eof ethe efollowing eblocks eshould ethe ebilling eand ecoding especialist
ecomplete eon ethe eCMS-1500 eclaim eform eform efor eprocedures, eservices eor
esupplies e(CPT/HCPCS)? e- ecorrect eanswers e-Block e24D
Which eof ethe efollowing eterms edescribes ewhen ea eplan epays e70% eof ethe
eallowed eamount eand ethe epatient epays e30%? e- ecorrect eanswers e-Coinsurance
A eprovider echarged e$500 eto eclaim ethat ehad ean eallowable eamount eof e$400.
eIn ewhich eof ethe efollowing ecolumns eshould ethe ebilling eand ecoding especialist
eapply ethe enon-allowed echarge? e- ecorrect eanswers e-Adjustment ecolumn eof ethe
ecredits
Which eof ethe efollowing eis ea eHIPAA ecompliance eguideline eaffecting eelectronic
ehealth erecords? e- ecorrect eanswers e-The eelectronic etransmission eand ecode
eset estandards erequire eevery eprovider eto euse ethe ehealthcare etransactions
e,code esets eand eidentifiers
Patient: eJane eAustin; eSocial eSecurity e# e555-22-1111; eMedicare eID: e555-33-
2222A; eDOB: e05/22/1945. eClaim einformation eentered: eAustin, eJane; eSocial
eSecurity e#.: e555-22-1111; eMedicare eID eNo.: e555-33-2222A; eDOB: e052245.
eWhich eof ethe efollowing eis ea ereason ethis eclaim ewas erejected? e- ecorrect
eanswers e-The eDOB eis eentered eincorrectly
Why edoes ecorrect eclaim eprocessing erely eon eaccurately ecompleted eencounter
eforms? e- ecorrect eanswers e-They estreamline epatient ebilling eby esummarizing
ethe eservices erendered efor ea egiven edate eof eservice
A epatient's ehealth eplan eis ereferred eto eas ethe e"payer eof elast eresort." eThe
epatient eis ecovered eby ewhich eof ethe efollowing ehealth eplans? e- ecorrect
eanswers e-Medicaid
Which eof ethe efollowing ecolor eformats eis eacceptable eon ethe eCMS-1500 eclaim
eform? e- ecorrect eanswers e-Red
Which eof ethe efollowing eis ean eexample eof ea eviolation eof ean eadult epatient's
econfidentiality? e- ecorrect eanswers e-Patient einformation ewas edisclosed eto ethe
epatient's eparents ewithout econsent.
In ethe eanesthesia esection eof ethe eCPT emanual, ewhich eof ethe efollowing eare
econsidered equalifying ecircumstances? e- ecorrect eanswers e-Add-on ecodes
