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CBCS Practice Test questions and answers already graded A+ 2025/2026
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CBCS Practice Test questions and answers already graded A+ 2025/2026
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CBCS Practice Test1. A beneficiary of a Medicare/Medicaid crossover claim submitted by way of a taking part
company is accountable for which of the following probabilities? - ANS-0%
2. When offerings are covered by way of both Medicare and Medicaid, the beneficiary isn't
always accountable for the price.
3. A biller will electronically publish a claim to the carrier thru which of the following? -
ANS-Direct Data Entry
4. A billing and coding professional can make sure suitable insurance insurance for an
outpatient procedure by using first the use of which of the subsequent method? -
ANS-Precertification
5. A billing and coding specialist has four past-due charges: $400 this is 10 weeks late;
$100 this is six weeks late; $1000 this is four weeks late; and $2000 that is eight weeks
late. Which of the following charges have to be sent to collections first? - ANS-$2000
6. A billing and coding expert is preparing a claim form for a provider from a group
exercise. The billing and coding specialist should enter the rendering vendors
countrywide issuer identifier into which of the following blocks at the CMS
7. -1500 claim shape? - ANS-Block 24j
8. A billing and coding specialist is reviewing a CMS-1500 declare form. The "task of
blessings" box has been checked "sure." The checked container shows which of the
following? - ANS-The provider receives fee without delay from the payer
9. A billing and Coding Specialist desires to recognize how a whole lot Medicare paid on a
declare before billing the secondary coverage. To which of the subsequent ought to the
professional refer? - ANS-remittance recommendation
10. A billing and coding specialist ought to upload modifier -52 codes whilst reporting which
of the subsequent? - ANS-Bilateral manner
11. A billing and coding specialist have to input the prior authorization variety on the
CMS-1500 claim shape in which of the following blocks? - ANS-Block 23
12. A billing and coding professional must automatically analyze which of the subsequent to
decide the variety of exceptional claims? - ANS-Aging report
13. A billing and coding expert ought to keep in mind that the monetary file source this is
generated via a company's office is called a? - ANS-Patient ledger account
14. A claim can be denied or rejected for which of the following motives? - ANS-Block 24D
carries the analysis code
15. A declare is denied because the carrier turned into not blanketed with the aid of the
coverage agency. Upon confirmation of no mistakes on the claim, which of the
subsequent describes the system a good way to follow the denial? - ANS-The claim will
now not be re-submitted and the affected person might be sent a invoice
16. A claim is denied because of termination of coverage. Which of the following movements
should the billing and coding specialist take next? - ANS-Following up with a affected
person to determine contemporary call, address, and coverage service for resubmission
,17. A claim is submitted with a transposed coverage member ID quantity and returned to the
issuer. Which of the following describes the repute that must be assigned to the claim
through the service? - ANS-invalid
18. A coroner's post-mortem is made from which of the following examinations? -
ANS-Gross examination
19. A deductible of $a hundred is carried out to a affected person's remittance advice. The
provider requests the account personnel write it off. Which of the subsequent terms
describes this scenario? - ANS-fraud
20. A based baby whose dad and mom both have coverage insurance come to the health
facility. The billing and coding expert makes use of the birthday rule determine which
coverage policy is primary. Which of the following describes the birthday rule? -
ANS-The patient whose birthday comes first within the calendar yr
21. A structured child whose mother and father each have insurance insurance comes to the
health facility. The billing and coding expert uses the birthday rule to decide which
insurance policy is number one. Which of the following describes the birthday rule? -
ANS-The parent whose birthday comes first within the calendar 12 months
22. A form that incorporates prices, DOS, CPT codes, ICD codes, prices, and copayment
data is called which of the following? - ANS-Encounter form
23. A husband and wife each have Group insurance thru their employers the wife has an
appointment together with her provider which insurance should be used as primary for
the appointment - ANS-The wife's coverage
24. A medicare non-collaborating companies authorized charge amount is $200 for a
lobectomy and the deductible has been met. Which of the subsequent quantities is the
restricting rate for this technique? - ANS-$230
25. A nurse is reviewing a sufferers lab effects prior to discharge and discovers an extended
glucose degree. Which of the fowling fitness care vendors ought to be alerted before the
nurse can proceed with the release planning? - ANS-The attending doctor
26. A participating Blue Cross Blue Shield provider gets a proof of benefits for a patient
account. The rate quantity became $a hundred. Blue Cross Blue Shield allowed $80 and
carried out $forty to the affected person's annual deductible. Blue Cross Blue Shield paid
the stability at 80%. How an awful lot need to the patient assume to pay? - ANS-$48
27. The patient will pay a $forty deductible and 20% of the $forty balance
28. A collaborating Blue Cross/Blue Shield (BC/BS) company gets an explanation of benefits
for a affected person account. The costs amount become $a hundred. BC/BS allowed
$80 and implemented $forty to the sufferers annual deductible. BC/BS paid the stability
at eighty%. How an awful lot have to the affected person anticipate to pay? - ANS-$48
29. The affected person pays a $forty deductible and 20% of the $forty stability
30. A affected person involves the sanatorium for an inpatient manner. Which of the
subsequent health center body of workers individuals is liable for the initial patient
interview, acquiring demographic and insurance information, and documenting the
leader complaint? - ANS-admitting clerk
31. A patient had AARP as secondary coverage l. In which of the subsequent blocks on the
CMS-1500 claim form ought to this statistics be entered? - ANS-Block 9a
, 32. A affected person has AARP a secondary insurance. In which of the subsequent blocks
at the CMS-1500 claim shape need to this information be entered? - ANS-Block 9
33. A affected person has an emergency appendectomy While on excursion. The declare is
rejected because of the patient obtaining carrier out of pocket. Which of the following
information have to be included inside the declare appeal? - ANS-The patient turned into
out of metropolis for the duration of the emergency
34. A patient has laboratory work carried out in the emergency branch after an inhalation of
poisonous fumes from a defective exhaust fan at her vicinity of Employment. Which of
the subsequent is accountable for the charges? - ANS-Workers compensation
35. A patient has met a Medicare deductible of $a hundred and fifty. The patient coinsurance
is 20% and the allowed quantity is $600. Which of the subsequent is the patients out of
pocket rate? - ANS-$a hundred and fifty
36. Since the affected person's deductible has been met the patient responsibilities 20% of
the allowed amount
37. A patient is pre-legal to acquire diet B 12 injections from January 1 to May 31. On June
2, the issuer orders an additional six months of injections. In order for the patient to
continue with insurance of care, which of the following must arise? - ANS-The provider
should contact the patient's coverage service to attain a brand new authorization
38. A affected person is disappointed approximately a bill she acquired. Her insurance
company denied the declare. Which of the subsequent moves is the ideal manner to
address the scenario? - ANS-Inform the patient of the purpose for the denial
39. A patient gives to the issuer with chest pain and shortness of breath. After an surprising
ECG result, The provider calls a cardiologist And summarizes the patient's signs. What
part of HIPAA permits the provider to speak to the heart specialist prior to obtaining the
affected person's consent? - ANS-Tittle II
40. A affected person offers to the provider with chest pain and shortness of breath. After
and sudden ECG result, the issuer calls a heart specialist and summarizes the patients
symptoms. What part of HIPAA permits the provider to talk to the cardiologist previous to
acquiring the patient's consent? - ANS-Title II
41. A patient who has a primary malignant neoplasm of the lung ought to be referred to
which of the following experts? - ANS-Pulmonary oncologist
42. A patient who has a number one malignant neoplasm of the lungs ought to be stated
which of the following specialist? - ANS-Pulmonary oncologist
43. A affected person who has an HMO insurance plan wishes to look a specialist for a
particular hassle. From which of the subsequent must the affected person attain a
referral? - ANS-Primary care company
44. A affected person who is an lively member of the military lately returned from distant
places and is in need of forte care. The affected person does no longer have anybody
targeted with electricity of legal professional. Which of the subsequent is taken into
consideration a HIPAA violation? - ANS-The billing and coding professional sends the
sufferers information to the sufferers companion
45. A affected person who's an active member of the navy these days back from remote
places and is in need of specialty care. The affected person does now not have
absolutely everyone certain with energy of eternity. Which of the subsequent is
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