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NHA CBCS Final Exam Questions and Answers | Verified Answers 2022/2023
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NHA CBCS Final Exam Questions and Answers 2022/20231. When a billing and coding specialist is completing the CMS-1500
claim form, which of the following information is required to process a
medical claim?: Answer- CPT, ICD
2. The allowed amount for a patient's office visit is $175. The copayment is
$15 and the amount the insurance paid is $85. Which of the following is the
amount of the adjustment?: Answer- $75
3. Which of the following suffixes refers to an abnormal condition?: Answer-
-osis
4. Which of the following entities contracts with Medicare to recoup
money form inappropriately paid claims?: Answer- Recovery Audit
Contractor
5. Which of the following abbreviations is used to describe the reason
a patient presents for an encounter at the office visit?: Answer- CC
6. A patient comes in the office with an injury form work. Which box on line
1 of the CMS-1500 claim from should the billing and coding specialist
check off to transmit the calm for payment?: Answer- FECA
7. Which of the following practices does HIPPA Title II define as fraud?:
Answer- Altering codes to increase payment
8. A provider charges $30 for a treatment that has an allowed of $25.
1/9
,Which of the following statements regarding this $5 difference between
the two amounts is correct?: Answer- The insurance payer pays the $5
if the provider is a par- ticipating provider.
9. A patient who has coinsurance and has met their deductible has
which of the following third-party payers?: Preferred provider
organization(PPO)
10.If a patient does not sign box 13 on the CMS-1500 form. Which of
the following will receive payment?: Provider
11.Which is the correct form?: Thomas Jr. Martin F
12.A patient has a diagnosis of chest pain. The billing and coding
specialist should link the diagnosis to the procedure in which of the
following blocks on the CMS- 1500 form?: 24D
13.A provider's office is being investigated for fraud. Which of the
following processes will be reviewed first?: Compliance Plan
2/9
, 14.Which of the following entities works with Centers for Medicare and
Medicaid services to prevent overpayment?: Medicaid Integrity
contractors
15.Which of the following actions by a billing and coding specialist is
insurance abuse?: Using a health insurance identification number other
than the patients to ensure payments
16.Which of the following refers to payers electronically transferring date
in order to facilitate coordination of benefits on a clean claim?: Crossover
17. Which of the following is responsible for the health care of its
policyhold- ers and identifies health insurance, facilities, providers, or
health systems?-
: Managed care Organization
18.A patient who has TRICARE is seen in the office for a diagnostic test.
The test is $500, and the allowable amount is $250. The patient has a 20%
cost share, a deductible of $1000, and a catastrophic cap benefit that have
all been met. How much should the billing specialist adjust on this visit?:
$200
19.Which of the following is the amount that the patient is financially
respon- sible for before the insurance policy provides coverage?:
Deductible
20.The balances listed on an insurance aging report represent which of
the following?: Outstanding amounts owed to the practice
21.To ensure all claims are being submitted and received, a billing and
3/9
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