NHA Practice Test # 1
Which of the following should the billing and coding specialist include in an authorization to release
information? - ANSWER-The entity to whom the information is to be released.
Which of the following actions should the billing and coding specialist take if they observes a colleague in
an unethical situation? - ANSWER-Report the incident to a supervisor, whom will then report to the
company compliance officer if need be.
When posting payment accurately, which of the following items should the billing and coding specialist
include? - ANSWER-The patient's responsibility (copay, deductible, or coinsurance)
A dependent child whose parents both have insurance coverage comes to the clinic. The billing and
coding specialist uses the birthday rule to determine which insurance policy is primary. Which of the
following describes the birthday rule? - ANSWER-The parent whose birthdate comes first in the calendar
year.
Which of the following statements is true regarding the release of patient records? - ANSWER-Patient
access to psychotherapy notes may be restricted.
A patient's employer has not submitted a premium payment. Which of the following claim statuses
should the provider receive from the third-party payer? - ANSWER-Denied; the patient technically does
not have insurance coverage since their plan is not active due to non-payment of premium.
Which of the following do physicians use to electronically submit claims? - ANSWER-Clearinghouse; an
independent organization that receives insurance claims from physicians' offices, performs software
edits, and distributes those claims electronically to third-party payers.
When coding on the UB-04 form, the billing and coding specialist must sequence the diagnosis codes
according to ICD guidelines. Which of the following is the first listed diagnosis code? - ANSWER-Principal
Diagnosis
A patient has AARP as secondary insurance. In which of the following blocks on the CMS-1500 claim form
should this information be entered? - ANSWER-Block 9
, According to HIPAA standards, which of the following identifies the rendering provider on the CMS-1500
claim form in Block 24j? - ANSWER-NPI
Which of the following provisions ensures that an insured's benefits from all insurance companies does
not exceed 100% of allowable medical expenses? - ANSWER-Coordination of benefits
Which of the following is the verbal or written agreement that gives approval to some action, situation,
or statement, and allows the release of patient information? - ANSWER-Consent agreement
A deductible of $100 is applied to a patient's remittance advice. The provider requests the account
personnel write it off. Which of the following terms describes this scenario? - ANSWER-Fraud
What is considered abuse in the medical field? - ANSWER-
What is considered waste in the medical field? - ANSWER-
A coroner's autopsy is comprised of which of the following examinations? - ANSWER-Gross examination
Which of the following is the advantage of electronic claim submission? - ANSWER-Claims are expedited.
A patient presents to the provider with chest pain and shortness of breath. After an unexpected ECG
result, the provider calls a cardiologist and summarizes the patient's symptoms. What portion of HIPAA
allows the provider to speak to the cardiologist prior to obtaining the patient's consent? - ANSWER-Title
2; This deals with the administrative simplifications, which include communication with parties involved
with the patient's care. The patient signs an agreement and is given a copy of the HIPAA standards upon
becoming a patient.
A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has Medicare as her
primary insurance. Which of the following forms is required so the patient knows she may be responsible
for payment? - ANSWER-Advanced Beneficiary Notice.
Which of the following should the billing and coding specialist include in an authorization to release
information? - ANSWER-The entity to whom the information is to be released.
Which of the following actions should the billing and coding specialist take if they observes a colleague in
an unethical situation? - ANSWER-Report the incident to a supervisor, whom will then report to the
company compliance officer if need be.
When posting payment accurately, which of the following items should the billing and coding specialist
include? - ANSWER-The patient's responsibility (copay, deductible, or coinsurance)
A dependent child whose parents both have insurance coverage comes to the clinic. The billing and
coding specialist uses the birthday rule to determine which insurance policy is primary. Which of the
following describes the birthday rule? - ANSWER-The parent whose birthdate comes first in the calendar
year.
Which of the following statements is true regarding the release of patient records? - ANSWER-Patient
access to psychotherapy notes may be restricted.
A patient's employer has not submitted a premium payment. Which of the following claim statuses
should the provider receive from the third-party payer? - ANSWER-Denied; the patient technically does
not have insurance coverage since their plan is not active due to non-payment of premium.
Which of the following do physicians use to electronically submit claims? - ANSWER-Clearinghouse; an
independent organization that receives insurance claims from physicians' offices, performs software
edits, and distributes those claims electronically to third-party payers.
When coding on the UB-04 form, the billing and coding specialist must sequence the diagnosis codes
according to ICD guidelines. Which of the following is the first listed diagnosis code? - ANSWER-Principal
Diagnosis
A patient has AARP as secondary insurance. In which of the following blocks on the CMS-1500 claim form
should this information be entered? - ANSWER-Block 9
, According to HIPAA standards, which of the following identifies the rendering provider on the CMS-1500
claim form in Block 24j? - ANSWER-NPI
Which of the following provisions ensures that an insured's benefits from all insurance companies does
not exceed 100% of allowable medical expenses? - ANSWER-Coordination of benefits
Which of the following is the verbal or written agreement that gives approval to some action, situation,
or statement, and allows the release of patient information? - ANSWER-Consent agreement
A deductible of $100 is applied to a patient's remittance advice. The provider requests the account
personnel write it off. Which of the following terms describes this scenario? - ANSWER-Fraud
What is considered abuse in the medical field? - ANSWER-
What is considered waste in the medical field? - ANSWER-
A coroner's autopsy is comprised of which of the following examinations? - ANSWER-Gross examination
Which of the following is the advantage of electronic claim submission? - ANSWER-Claims are expedited.
A patient presents to the provider with chest pain and shortness of breath. After an unexpected ECG
result, the provider calls a cardiologist and summarizes the patient's symptoms. What portion of HIPAA
allows the provider to speak to the cardiologist prior to obtaining the patient's consent? - ANSWER-Title
2; This deals with the administrative simplifications, which include communication with parties involved
with the patient's care. The patient signs an agreement and is given a copy of the HIPAA standards upon
becoming a patient.
A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has Medicare as her
primary insurance. Which of the following forms is required so the patient knows she may be responsible
for payment? - ANSWER-Advanced Beneficiary Notice.
