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NHA CBCS Certification Practice Exam A/103 Q’s and A’s (NHA practice exam version A)
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NHA CBCS Certification Practice Exam A/103 Q’s and A’s (NHA practice exam version A)
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NHA CBCS Certification Practice Exam A/103Q’s and A’s (NHA practice exam version A)
Which of the following is considered the final determination of the issues
involving the settlement of an insurance claim? - -Adjudication - is the
process of putting an insurance claim through a series of edits for final
determination.
Chapter 4
-A form that contains charges, DOS, CPT codes, fees, and copayment
information is called which of the following? - -Encounter form is a form that
contains charges, DOS, CPT code, ICD codes, fees, and copayment
information.
page 67
-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? - -Admitting these duties clerk has
Chapter 3
-Which of the following privacy measures ensures protected health
information (PHI)? - -Using data encryption software on office workstations -
encryption software ensures that electronically transmitted health
information cannot be read by third parties. This privacy measure
guarantees PHI.
Chapter 1
-Which of the following planes divide the body into left and right? - -Sagittal
plane divides the body into right and left sections
-Which of the following provisions ensures that an insured's benefits from all
insurance companies do not exceed 100% of allowable medical expenses? -
-Coordination of benefits ensures that the insured benefits from all insured
companies do not exceed 100% of allowable medical expenses.
page 16
-Which of the following actions should be taken first when reviewing a
delinquent claim? - -Verify the age of the account is the first action.
page 45
-Which of the following is the advantage of electronic claim submission? - -
Claims are expedited - submitting claims electronically is faster than
submitting paper claims.
page 15
, -Which of the following components of an explanation of benefits expedites
the process of a phone appeal? - -Claim control number expedites the
process of a phone appeal.
Chapter 4
-The standard medical abbreviation "ECG" refers to a test used to assess
which of the following body systems? - -Cardiovascular system- which is a
test that checks for problems with the electrical activity of the heart.
Chapter 5
-Which of the following actions by a billing coding specialist (bcs) would be
considered fraud? - -Billing for a service not provided is considered fraud
and can result in fines for the bcs and the physician page 6
-The "> <" symbol is used to indicate new and revised text other than which
of the following? - -Procedures descriptors Chapter 5
-On the CMS-1500 claim form, blocks 14 through 33 contain information
about which of the following? - -The patient's condition and the provider's
information are found on the CMS-1500 at blocks 14 - 33 page 21
-Which of the following includes procedures and best practices for correct
coding? - -Coding Compliance Plan contains rules, procedures, and best
practices to ensure accurate coding.
Chapter 5
-When completing a CMS-1500 paper claim form, which of the following is
an acceptable action for the bcs to take? - -Use Arial size 10 font or OCR size
10-, or 12-point for paper claims.
Chapter 2
-A participating BCBS provider received an explanation of benefits for a
patient account. The charge 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? - -$48 page 38-39
-Which of the following indicates a claim should be submitted on paper
instead of electronically? - -The claim requires an attachment - should
submit a paper form if the claim requires an attachment.
Chapter 2
-According to HIPAA standards, which of the following identifies the
rendering provider on the CMS-1500 claim form in Block 24J? - -NPI Page 23
, -Which of the following blocks should the bcs complete on the CMS-1500
form for procedures, services, or supplies? - -Block 24D.
Page 23
-Which of the following terms describes when a plan pays 70% of the
allowed and the patient pays 30%? - -Coinsurance is a percentage of the
cost for covered services that is approved by the insurance company.
Page 39
-A provider charges $500 to a claim that had an allowable amount of $400.
In which of the following columns should the bcs apply the non-allowed
charge? - -The adjustment column of the credits is where adjustments are
recorded.
page 47
-Which of the following is a HIPAA compliance guideline affecting electronic
health records? - -The Health Information Technology for Economic and
Clinical (HITECH) Act encrypts provider - protected health information
page 1 & 3
-Patient: Justin Austin; Social Security NO.: 555-22-1111; Medicare ID NO.:
555-33-2222A; DOB: 05/22/1945. Claim information entered: Austin, Jane;
Social Security No.: 555-22-111; Medicare ID No.: 555-33-2222A; DOB:
052245. Which of the following is a reason the claim was rejected? - -The
DOB is entered incorrectly - the format is two digits for the month and four
digits for the year.
page 18
-Why does correct claim processing rely on accurately completed encounter
forms? - -They streamline patient billing by summarizing the services
rendered for a given date of service - encounter forms allow a provider to
summarize services rendered by code, which reduces time spent by bcs
when posting charges. Page 18
-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? - -Medicaid is the
health plan that is referred to as the "payor of last resort." All of the patient's
health plans must meet their obligations before Medicaid will pay.
page 30
-Which of the following color formats allows optical scanning of the CMS-
1500 claim form? - -Red ink allows optical scanning of the CMS-1500.
Chapter 2
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