Exam (elaborations)
AAPC CPB Final QUESTIONS AND CORRECT ANSWERS(VERIFIED ANSWERS)|A+ GRADE 2025/2026
AAPC CPB Final QUESTIONS AND CORRECT ANSWERS(VERIFIED ANSWERS)|A+ GRADE 2025/2026
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AAPC CPB Final1. ___ provider with general obligation for the patient's hospital treatment at some stage in
hospitalization. - ANS-attending
2. ____ sets requirements and directives to guard people in opposition to transmission of
infectious dealers. - ANS-OSHA
3. ________ is while the company has limited get admission to to payer and affected
person statistics elements on their patients simplest. - ANS-extranet
4. "with evaluation" does now not include ___ assessment (for CT Scan) - ANS-oral, rectal
5. A ___ is used to indicate an inpatient service is pronounced on an outpatient claim. -
ANS-situation code
6. A ______ indicates the area or form of provider furnished for an inpatient and is said
with _______. - ANS-revenue code
7. 4 digit code
8. A ____________ is a listing of every single process that a clinic can provide to its
patients which are billed to payers. - ANS-chargemaster
9. A 68-year-antique Medicare patient provided for an annual examination and had no
court cases. Her claim, billed as 99387, turned into denied. Was this billed effectively? If
not, how is that this stumble upon successfully billed? - ANS-it relies upon on doc
10. A claim is submitted for a patient on Medicare with a better fee than a affected person on
Insurance ABC. What is this considered by means of CMS? - ANS-abuse
11. a company umbrella for control of assorted healthcare delivery structures - ANS-IPO
12. A cut price given to self-pay patients when they pay on the time of carrier. - ANS-prompt
fee bargain
13. A fee schedule can be based on - ANS-RVUs
14. A health plan sends a request for clinical statistics with the intention to adjudicate a
declare. Does the office must notify the affected person or have them signal a release to
send the facts? - ANS-no
15. A healthcare business enterprise with 2 hospitals, 20 clinics, and 3 pressing care
facilities belongs to an ACO program. They had been in the shared savings application
for 2 years and are actually eligible to move massive bills to a populace-based model as
they were a hit in preserving costs down and have met all of the CMS benchmarks set
for them. What form of ACO is this? - ANS-Pioneer
16. A health center chargemaster does NOT include which of the subsequent? -
ANS-ICD10CM codes
17. A sanatorium records transporter is transferring medical information from the clinic to an
off-web site constructing. During the shipping, a chart falls from the box directly to the
street. It is observed whilst the transporter arrives at the off-web site constructing and the
wide variety of charts isn't always correct. What form of violation is that this? -
ANS-breach
, 18. A Medicare affected person presents after slipping and falling in a neighbor's walkway.
The cement had a large crack, which triggered the pavement to elevate and be
unsteady. The neighbor has contacted his home owner's coverage and they're accepting
legal responsibility and feature initiated a claim. How must the go to be billed? -
ANS-Homeowners, then Medicare
19. A new physician comes in to the practice that is just out of scientific college. He will want
with a view to see sufferers within the workplace and at the health center. What system
will he want to go through a good way to be able to participate with Medicare and other
fitness plans? - ANS-credentialling
20. A new radiology employer opens on the town. The supervisor calls your practice and
offers to pay $20 for every Medicare patient you ship to them for radiology offerings.
What does this offer violate? - ANS-anti kickback legal guidelines
21. A affected person is involved in an coincidence at paintings and their commercial
insurance is billed. What form of denial may be acquired? - ANS-legal responsibility
trouble
22. A patient imparting for care does now not have an coverage card and is billed CPT
99213 for $a hundred. The affected person will pay $100 to the provider. A week later,
the affected person gives verification of insurance thru Medicaid for this date of service.
What system must be observed? - ANS-record a claim to Medicaid w EOB
23. A individual that documents a claim for a Medicare beneficiary knowing that the service
isn't always effectively mentioned is in violation of what statute? - ANS-False Claims Act
24. A plan wherein a provider accepts a hard and fast, pre-set up monthly payment for
enrollees in a medical health insurance plan - ANS-capitated
25. A exercise agrees to pay $250,000 to settle a lawsuit alleging that the practice used
X-rays of 1 affected person to justify services on multiple other patients' claims. The
manager of the office delivered the civil in shape. What form of case is this? - ANS-qui
tam
26. A practice permits patients to pay large balances over a six month time period with a
finance charge carried out. The patient gets a announcement each month that best
indicates the unpaid stability. What does this violate? - ANS-TILA
27. A exercise sets up a payment plan with a patient. If greater than 4 installments are
extended to the affected person, what regulation is the exercise concern to that makes
the practice a creditor? - ANS-Truth in Lending Act
28. A personal practice hires a representative to are available and audit some clinical
statistics. Under the Privacy Rule, what's this consultant considered? - ANS-biz partner
29. A request for medical statistics is received for a selected date of provider from patient's
coverage organisation almost about a submitted declare. No authorization for release of
facts is furnished. What action need to be taken? - ANS-release reqt to ins co
30. A savings account that allows individuals to keep pre-tax bucks to reimburse for
healthcare fees is known as a(n): - ANS-FSA, HSA
31. a completely unique 10-digit identity variety required by using HIPAA - ANS-NPI
32. According to Aetna's posted hints, what is the time-frame for filing an appeal? - ANS-60
days
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