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CBCS practice test/254 Complete Questions with Answers
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CBCS practice test/254 CompleteQuestions with Answers
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
CHAMPA
Medicare
TRICARE - -Medicaid
-A provider charged $500 to a claim that had an allowable amount of $400.
In which of the following columns should the CBCS apply the non allowed
charge?
-Reference column (For notations)
-Description column
-Payment column
-Adjustment column of the credits - -Adjustment column of the credits
-Which of the following statements is correct regarding a deductible?
-Coinsurance is a type of deductible
-The physician should write off the deductible
-The insurance company pays for the deductible
-The deductible is the patient's responsibility - -The deductible is the
patient's responsibility
-Which of the following color formats allows optical scanning of the CMS-
1500 claim form?
-Red
-Blue
-Green
-black - -red
-Ambulatory surgery centers, home health and hospice organizations use
the ______.
-CMS-1500 claim form
-UB-04 claim form
-Advance Beneficiary notice
-First report of injury form - -UB-04
-Claims that are submitted without an NPI number will delay payment to the
provider because ______.
-The number is the patient' id number
-The number is needed to identify the provider
-Is is used as a claim number
,-It is used as a pre authorization number - -The number is needed to identify
the provider
-Which of the following terms describes when a plan pays 70% of the
allowed amount and the patient pays 30%?
-Coinsurance
-Deductible
-Premium
-copayment - -coinsurance
-Which of the following indicates a claim should be submitted on paper
instead of electronically?
-The software claims review process indicates the claim is not complete
-The claim needs authorization
-The claim requires an attachment
-The practice management software is non functional. - -the claim requires
an attachment
-On a remittance advice form, which of the following is responsible for
writing off the difference between the amount billed and the amount allowed
by the agreement?
-Provider
-Insurance company
-Patient
-Third party payer - -provider
-A physician is contracted with an insurance company to accept the amount.
The insurance company allows $80 of a $120 billed amount, and $50 of the
deductible has not been met. How much should the physician write off the
patient's account?
-$40
-$15
-$0
-$50 - -$40
-The unlisted codes can be found in which of the following locations in the
CPT manual?
-Appendix L
-Guidelines prior to each section
-End of each body system
-Table of contents - -Guidelines prior to each section
-Which of the following blocks should the billing and coding specialist
complete the CMS 1500 claims form for procedure, services or supplies?
-Block 12
-Block 2
,-Block 24D
-Block 24J - -Block 24D
-Block 12 (patient's authorization block
-Block 2 ( patient's name)
-Block 24J ( for the rendering provider)
-Which of the following blocks requires the patient's authorization to release
medical information to process a claim?
Block 12
Block 13
Block 27
Block 31 - -Block 12
- Block 13 patient authorization for benefits required for third party payer
- Block 27 accepting assignment of benefits
- Block 31 (treating physician)
-Which of the following steps would be part of a physician's practice
compliance program?
-HIPAA compliance audit
-Physician recruitment
-Internal monitoring and auditing
-Notice of privacy practice - -Internal monitoring and auditing
-Behavior plays an important part of being a team player in a medical
practice. Which of the following is an appropriate action for the CBCS to
take?
-Reprimanding another staff member during a team meeting for displaying a
bad attitude toward a patient
-Looking in the medical record of a friend who receives services at the office
-Communicating with the front desk staff during a team meeting about
missing information in patient files
-Questioning the nurse about the provider documentation in the medical
record - -Communicating with the front desk staff during a team meeting
about missing information in patient files
-Which of the following acts applies to the administrative simplification
guideline?
-HIPAA
-Deficit reduction act of 2005
-The patient protection and affordable care act 2009
-National correct coding initiative of 1995 - -HIPAA
-Which of the following is an example of a violation of an adult patient's
confidentiality?
-While reviewing a claim, the CBCS reads the diagnosis before realizing that
the patient is a neighbor
, -A CBCS queries the physician about a diagnosis in a patient's medical record
-The physician uses his home phone to discuss patient care with the nursing
staff
-Patient information was disclosed to the patient's parents without consent -
-Patient information was disclosed to the patient's parents without consent
-Which of the following is the purpose of running an aging report each
month?
-If indicates the balances the patients owe the provider
-It indicates which patients have upcoming or missed appointment
-It indicates which claims are outstanding
-It indicates what the insurance company has paid for the provider's services
to a patient. - -It indicates which claims are outstanding
-Which of the following describes the status of a claim that does not include
the required preauthorization for a service?
-Delinquent (overdue)
-Denied
-Suspended
-Adjudicated (claim still being processed) - -Denied
-Delinquent (overdue)
-Adjudicated (claim still being processed)
-Which of the following actions should the CBCS take to prevent fraud and
abuse in the medical office?
-Serviced procedure preauthorization
-Internal monitoring and auditing
-Utilization review
-Correct coding initiative - -Internal monitoring and auditing
-In an outpatient setting, which of the following forms is used as a financial
report of all services provided to patients?
-Encounter form
-Patient account record
-CMS-1500 claim form
-Accounts receivable journal - -Patient account record (patient ledger, all
transactions between patient and the practice)
-Accounts receivable journal (Day sheet = chronological summary of all
transaction on a specific day)
-Patient charges that have not been paid will appear in which of the
following?
-Accounts receivable
-Accounts payable
-Tracer
-Rejected claim - -Accounts receivable
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