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AAPC CPB Practice Exam Questions and Correct Answers | Latest Update
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Joe and Mary are a married couple and both carry insurance from their employers. Joe was born on February 23, 1977 and Mary was born on April 4, 1974. Using the birthday rule, who carries the primary insurance for their children for billing? A. Joe, because he is the male head of the househo...

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  • September 24, 2024
  • 147
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • aapc cpb practice exam questions and correct answ
  • joe and mary are a married couple and both carry i

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1 | P a g e | © copyright 2024/2025 | Grade A+




AAPC CPB Practice Exam Questions
and Correct Answers | Latest
Update
Joe and Mary are a married couple and both carry insurance from their

employers. Joe was born on February 23, 1977 and Mary was born on April 4,

1974. Using the birthday rule, who carries the primary insurance for their

children for billing?




A. Joe, because he is the male head of the household.

B. Mary, because her date of birth is the 4th and Joe's date of birth is the

23rd.

C. Mary, because her birth year is before Joe's birth year.

D. Joe, because his birth month and day are before Mary's birth month and

day.


→ ::- D. Joe, because his birth month and day are before Mary's birth

month and day.




Which type of managed care insurance allows patients to self-refer to out-of-

network providers and pay a higher co-insurance/copay amount?




I. HMO


Master01 | September, 2024/2025 | Latest update

, 1 | P a g e | © copyright 2024/2025 | Grade A+


II. PPO

III. EPO

IV. POS

V. Capitation




A. II

B. IV

C. II and IV

D. II, III, and V


→ ::- C. II and IV




A patient covered by a PPO is scheduled for knee replacement surgery. The

biller contacts the insurance carrier to verify benefits and preauthorize the

procedure. The carrier verifies the patient has a $500 deductible which must

be met. After the deductible, the PPO will pay 80% of the claim. The

contracted rate for the procedure is $2,500. What is the patient's

responsibility?




A. $400

B. $500

C. $900


Master01 | September, 2024/2025 | Latest update

, 1 | P a g e | © copyright 2024/2025 | Grade A+


D. $1,600


→ ::- C. $900




When a nonparticipating provider files a claim for a patient to BC/BS, how is

the payment processed?




A. The payment is sent to the patient and the patient must pay the provider.

B. The payment is sent to the provider if the provider agrees to accept

assignment.

C. The payment is sent to the provider regardless if he accepts assignment.

D. The claim is not paid because the provider is not participating in the plan.


→ ::- A. The payment is sent to the patient and the patient must pay the

provider.




Which of the following TRICARE options is/are available to active duty service

members?




A. TRICARE Select

B. TRICARE Prime

C. TRICARE For Life

D. TRICARE Young Adult


Master01 | September, 2024/2025 | Latest update

, 1 | P a g e | © copyright 2024/2025 | Grade A+


→ ::- B. TRICARE Prime




A Medicare card will list which of the following:




I. Effective date of coverage

II. Home address

III. Telephone Number

IV. Entitled to Part A and/or Part B

V. When coverage ends

VI. Name of Primary Care Physician




A. I - VI

B. I, IV

C. I-III, VI

D. I, II, IV, V


→ ::- B. I, IV




In which of the following scenarios is Medicare the secondary payer?




Master01 | September, 2024/2025 | Latest update

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