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NHA CBCS CERTIFICATION 2024/2025 graded A+
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NHA CBCS CERTIFICATION 2024/2025 graded A+
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NHA CBCS CERTIFICATIONWhich of the following is considered the final determination of the issues involving settlement
of an insurance claim? - ANSAdjudication
A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information
is called which of the following? - ANSEncounter form
A patient comes to the hospital for an inpatient procedure. Which of the following hospital
staff members is responsible for the initial patient interview, obtaining demographic and
insurance information, and documenting the chief complaint? - ANSAdmitting clerk
Which of the following privacy measures ensures protected health information (phi)? -
ANSUsing data encryption software on office workstations
Which of the following planes divides the body into left and right? - ANSSagittal
Which of the following provisions ensures that an insured's benefits from all insurance
companies do not exceed 100% of allowable medical expenses? - ANSCoordination of
benefits
Which of the following actions should be taken first when reviewing a delinquent claim? -
ANSVerify the age of the account
Which of the following is the advantage of electronic claim submission? - ANSClaims are
expedited
Which of the following components of an explanation of benefits expedites the process of a
phone appeal? - ANSClaim control number
The standard medical abbreviation ECG refers to a test used to assess which of the
following body systems? - ANSCardiovascular system
Which of the following actions by a billing and coding specialist would be considered fraud? -
ANSBilling for services not provided
The >< symbol is used to indicate a new and revised test other than which of the following? -
ANSProcedure descriptors
On the CMS-1500 claim form, blocks 14 through 33 contain information about which of the
following? - ANSThe patient's condition and the provider's information
Which of the following includes procedures and best practices for correct coding? -
ANSCoding Compliance Plan
, When completing a CMS-1500 paper claim form, which of the following is an acceptable
action for the billing and coding specialist to take? - ANSUse arial size 10 font
A participating blue cross/blue shield (BC/BS) provider receives an explanation of benefits
for a patient account. The charged amount was $100. BC/BS allowed $80 and applied $40
to the patient's annual deductible. BC/BS paid the balance at 80%. How much should the
patient expect to pay? - ANS$48
Which of the following indicates a claim should be submitted on paper instead of
electronically? - ANSThe claim requires an attachment
According to HIPAA standards, which of the following identifies the rendering provider on the
CMS-1500 claim form in block 24j? - ANSNPI
Which of the following blocks should the billing and coding specialist complete on the
CMS-1500 claim form form for procedures, services or supplies (CPT/HCPCS)? - ANSBlock
24D
Which of the following terms describes when a plan pays 70% of the allowed amount and
the patient pays 30%? - ANSCoinsurance
A provider charged $500 to claim that had an allowable amount of $400. In which of the
following columns should the billing and coding specialist apply the non-allowed charge? -
ANSAdjustment column of the credits
Which of the following is a HIPAA compliance guideline affecting electronic health records? -
ANSThe electronic transmission and code set standards require every provider to use the
healthcare transactions ,code sets and identifiers
Patient: Jane Austin; Social Security # 555-22-1111; Medicare ID: 555-33-2222A; DOB:
05/22/1945. Claim information entered: Austin, Jane; Social Security #.: 555-22-1111;
Medicare ID No.: 555-33-2222A; DOB: 052245. Which of the following is a reason this claim
was rejected? - ANSThe DOB is entered incorrectly
Why does correct claim processing rely on accurately completed encounter forms? -
ANSThey streamline patient billing by summarizing the services rendered for a given date of
service
A patient's health plan is referred to as the "payer of last resort." The patient is covered by
which of the following health plans? - ANSMedicaid
Which of the following color formats is acceptable on the CMS-1500 claim form? - ANSRed
Which of the following is an example of a violation of an adult patient's confidentiality? -
ANSPatient information was disclosed to the patient's parents without consent.
In the anesthesia section of the CPT manual, which of the following are considered
qualifying circumstances? - ANSAdd-on codes
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