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AAPC CPB - Practice Exam A Practice Questions and Answers
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AAPC CPB - Practice Exam A Practice Questions and Answers 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 bill...

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  • October 30, 2024
  • 26
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • aapc cpb practice exam a practice questions and

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  • CPB
  • CPB

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©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




AAPC CPB - Practice Exam A Practice

Questions and Answers


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. - ANSWER✔✔-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?




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, ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




I. HMO


II. PPO


III. EPO


IV. POS


V. Capitation




A. II


B. IV


C. II and IV


D. II, III, and V - ANSWER✔✔-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
Page 2/26

, ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




B. $500


C. $900


D. $1,600 - ANSWER✔✔-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. - ANSWER✔✔-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

Page 3/26

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