NHA CBCS EXAM VERSION 3
CONTENT
120+ multiple-choice Q&As with answers
HIPAA & Compliance (PHI, privacy officer, fraud/abuse, OIG, Stark Law)
Medical Billing Process (claims life cycle, scrubbers, clearinghouses, denials,
appeals)
Insurance Programs (Medicare Parts A–D, Medicaid, TRICARE, HMO,
PPO, POS)
Coding Systems (ICD-10-CM, CPT, modifiers, Z codes, CPT symbols)
Claims & Reimbursement (CMS-1500, EOB, ERA, patient responsibility,
COB, ABN)
Accounts Receivable & Collections (aging reports, remittance advice,
adjustments)
Legal & Regulatory (NCD, LCD, RAC audits, fraud/abuse penalties)
Documentation (SOAP notes, operative reports, encounter forms)
Terminology & Anatomy (anastomosis, exenteration, allograft, colostomy)
,Consist of 120 multichoice Questions with Answers
1. A specialist is submitting a batch of claims to the clearinghouse and re- ceived a
report stating three claims were rejected. What should the specialists next steps
be?
A. Build a patient for service is not covered
B. Reviews of scrubber report
C. Call the third-party payer to determine the reason for rejection
D. Appeal the rejection
Answer
Review the scrubber report
2. Which of the following actions should be taken by a specialist to ensure a
patient's health information is protected? A. Confirming test results with the
patient over the phone at the reception area.
B. Asking the patients reason for their visit during check-in.
C. Using data encryption software on office workstation.
D. Leaving the workstation unlocked while stepping away to assist another
patient.
Answer
Using data encryption software on office workstations
3. Which of the following is an advantage of an electronic claims submission?
,A. Claims are expedited.
B. Claims are scrubbed.
C. Claims are clean.
D. Claims are paid.
Answer
Claims are expedited
4. Which describes a CPT modifier that is used to indicate a provider super- vised
and interpreted a radiology procedure?
A. Technical component.
B. Professional component.
C. Descriptive qualifier.
D. Physical status.
Answer
Professional component
5. A specialist is assisting a patient who has a capitatef HMO and presented to
the office with a sinus infection. The specialist should identify that which of the
following is a statement that is true regarding a capitated HMO?
A. Payment for the encounter is based on the flat rate.
B. A claim should be submitted to the third-party payer for the encounter.
C. Patients are billed directly for the encounter.
D. A claim should be provided to the patient following the encounter.
, Answer
Payment for the encounter is based on a flat rate
6. A specialist is training a new employee on a claim for consultation.The new
employee asks " What is a consultation ", which of the following responses fits
best?
A it's when a provider request medical advice from nursing staff.
CONTENT
120+ multiple-choice Q&As with answers
HIPAA & Compliance (PHI, privacy officer, fraud/abuse, OIG, Stark Law)
Medical Billing Process (claims life cycle, scrubbers, clearinghouses, denials,
appeals)
Insurance Programs (Medicare Parts A–D, Medicaid, TRICARE, HMO,
PPO, POS)
Coding Systems (ICD-10-CM, CPT, modifiers, Z codes, CPT symbols)
Claims & Reimbursement (CMS-1500, EOB, ERA, patient responsibility,
COB, ABN)
Accounts Receivable & Collections (aging reports, remittance advice,
adjustments)
Legal & Regulatory (NCD, LCD, RAC audits, fraud/abuse penalties)
Documentation (SOAP notes, operative reports, encounter forms)
Terminology & Anatomy (anastomosis, exenteration, allograft, colostomy)
,Consist of 120 multichoice Questions with Answers
1. A specialist is submitting a batch of claims to the clearinghouse and re- ceived a
report stating three claims were rejected. What should the specialists next steps
be?
A. Build a patient for service is not covered
B. Reviews of scrubber report
C. Call the third-party payer to determine the reason for rejection
D. Appeal the rejection
Answer
Review the scrubber report
2. Which of the following actions should be taken by a specialist to ensure a
patient's health information is protected? A. Confirming test results with the
patient over the phone at the reception area.
B. Asking the patients reason for their visit during check-in.
C. Using data encryption software on office workstation.
D. Leaving the workstation unlocked while stepping away to assist another
patient.
Answer
Using data encryption software on office workstations
3. Which of the following is an advantage of an electronic claims submission?
,A. Claims are expedited.
B. Claims are scrubbed.
C. Claims are clean.
D. Claims are paid.
Answer
Claims are expedited
4. Which describes a CPT modifier that is used to indicate a provider super- vised
and interpreted a radiology procedure?
A. Technical component.
B. Professional component.
C. Descriptive qualifier.
D. Physical status.
Answer
Professional component
5. A specialist is assisting a patient who has a capitatef HMO and presented to
the office with a sinus infection. The specialist should identify that which of the
following is a statement that is true regarding a capitated HMO?
A. Payment for the encounter is based on the flat rate.
B. A claim should be submitted to the third-party payer for the encounter.
C. Patients are billed directly for the encounter.
D. A claim should be provided to the patient following the encounter.
, Answer
Payment for the encounter is based on a flat rate
6. A specialist is training a new employee on a claim for consultation.The new
employee asks " What is a consultation ", which of the following responses fits
best?
A it's when a provider request medical advice from nursing staff.
