NHA CBCS ACTUAL EXAM PAPER 2026
QUESTIONS WITH ANSWERS GRADED A+
◉ abuse. Answer: practices that directly or indirectly result in
unnecessary costs to the Medicare program
◉ account number. Answer: Number that identifies specific episode of
care, date of service, or patient.
◉ accounts receivable department. Answer: Department that keeps track
of what third-party payers the provider is waiting to hear from and what
patients are due to make a payment.
◉ activity/status date. Answer: Indicates the most recent activity of an
item.
◉ actual charge. Answer: The amount the provider charges for the health
care service.
◉ Administration Simplification Compliance Act. Answer: specifically
prohibits any payment by Medicare for services or medically necessary
supplies that are not submitted electronically
,◉ administrative services only contract. Answer: Contract between
employers and private insurers under which employers fund the plans
themselves, and the private insurance administers the plans for
employees.
◉ balance billing. Answer: Billing patients for charges in excess of the
Medicare fee schedule.
◉ batch. Answer: a group of submitted claims
◉ Blue Cross and Blue Shield plan. Answer: The first prepaid plan in
the U.S. that offers health insurance to individuals, small businesses,
seniors, and large employer groups.
◉ business associate. Answer: Individuals, groups, or organizations,
who are not members of a covered entity's workforce, that perform
functions or activities on behalf of or for a covered entity.
◉ Advance Beneficiary Notice of Noncoverage (ABN). Answer: Form
provided if a provider believes that a service may be declined because
Medicare might consider it unnecessary.
◉ aging report. Answer: Measures the outstanding balances in each
account.
, ◉ allowable charge. Answer: The amount an insurer will accept as full
payment, minus applicable cost sharing.
◉ APC grouper. Answer: Helps coders determine the appropriate
ambulatory payment classification (APC) for an outpatient encounter.
◉ assignment of benefits. Answer: Contract in which the provider
directly bills the payer and accepts the allowable charge.
◉ auditing. Answer: Review of claims for accuracy and completeness.
◉ authorization. Answer: Permission granted by the patient or the
patient's representative to release information for reasons other than
treatment, payment, or health care operations.
◉ capitation. Answer: The fixed amount a provider receives.
◉ case management. Answer: a review of clinical services being
performed
◉ category I cpt code. Answer: Code that covers physicians' services
and hospital outpatient coding.
QUESTIONS WITH ANSWERS GRADED A+
◉ abuse. Answer: practices that directly or indirectly result in
unnecessary costs to the Medicare program
◉ account number. Answer: Number that identifies specific episode of
care, date of service, or patient.
◉ accounts receivable department. Answer: Department that keeps track
of what third-party payers the provider is waiting to hear from and what
patients are due to make a payment.
◉ activity/status date. Answer: Indicates the most recent activity of an
item.
◉ actual charge. Answer: The amount the provider charges for the health
care service.
◉ Administration Simplification Compliance Act. Answer: specifically
prohibits any payment by Medicare for services or medically necessary
supplies that are not submitted electronically
,◉ administrative services only contract. Answer: Contract between
employers and private insurers under which employers fund the plans
themselves, and the private insurance administers the plans for
employees.
◉ balance billing. Answer: Billing patients for charges in excess of the
Medicare fee schedule.
◉ batch. Answer: a group of submitted claims
◉ Blue Cross and Blue Shield plan. Answer: The first prepaid plan in
the U.S. that offers health insurance to individuals, small businesses,
seniors, and large employer groups.
◉ business associate. Answer: Individuals, groups, or organizations,
who are not members of a covered entity's workforce, that perform
functions or activities on behalf of or for a covered entity.
◉ Advance Beneficiary Notice of Noncoverage (ABN). Answer: Form
provided if a provider believes that a service may be declined because
Medicare might consider it unnecessary.
◉ aging report. Answer: Measures the outstanding balances in each
account.
, ◉ allowable charge. Answer: The amount an insurer will accept as full
payment, minus applicable cost sharing.
◉ APC grouper. Answer: Helps coders determine the appropriate
ambulatory payment classification (APC) for an outpatient encounter.
◉ assignment of benefits. Answer: Contract in which the provider
directly bills the payer and accepts the allowable charge.
◉ auditing. Answer: Review of claims for accuracy and completeness.
◉ authorization. Answer: Permission granted by the patient or the
patient's representative to release information for reasons other than
treatment, payment, or health care operations.
◉ capitation. Answer: The fixed amount a provider receives.
◉ case management. Answer: a review of clinical services being
performed
◉ category I cpt code. Answer: Code that covers physicians' services
and hospital outpatient coding.
