AAPC CPB Exams Bundle | Verified |

AAPC CPB - Practice Exam A: Questions and answers, rated A+ 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 ...

CPB Final Exam Questions and answers, rated A+ A practice agrees to pay $250,000.00 to settle a lawsuit alleging that the practice used x-rays of one patient to justify services on multiple other patients' claims. The office manager brought the civil suit. What type of case is this? - -Qui T...

CPB Exam Study Guide. Questions and answers, rated A+ What is the drawback of an HMO? - -A. Providers have an incentive to keep treatment cost at a minimum. B. The HMO administrators determine what services are reimbursed and what is not. C. The provider is now a gatekeeper to the patient's ...

CPB Final Exam Review Questions and answers, VERIFIED/ Electronic data interchange - -EDI Treatment, payment and operations - -TPO Conditions of participation - -COP False claim act - -FCA Health information portability and accountability act - -HIPAA Preferred provider organization - -PPO ...

CPB Practice Exam A: Questions and answers, rated A+ The office policy for claims follow-up is to prioritize the insurance balance accounts past 90 days by highest outstanding balance. Based on the A/R report provided, which payer type and aging category would be one of the top priorities on ...

AAPC CPB - Chapter 1 Review Questions and answers, rated A+ What does the acronym PHI stand for? a. Patient Healthcare Information b. Patient History of Illness c. Protected Health Information d. Protected Healthcare Index - -c. Protected Health Information A new radiology company opens in to...

CPB Final Exam questions and answers, rated A+ EPO - -...provides benefits to subscribers who are required to receive services from network providers IDS - -...organizations of affiliated providers sites that offer joint healthcare services to subscribers HMO - -...providers comprehensive hea...

AAPC CPB - CHAPTER 1: QUESTIONS & Answers, VERIFIED./ Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination ...

CPB Exam B: Review Questions and answers, rated A+ What is the term for the total amount of covered medical expenses a policyholder must pay each year out-of-pocket before the health insurance company begins to pay any benefits? - -Deductible Which type of insurance covers physicians and other...

AAPC CPB - Chapter 2 Review Questions and answers. Rated A+ What is the largest health program in the United States? a. Blue Cross Blue Shield b. Medicare c. Medicaid d. TRICARE - -b. Medicare Which of the following services is NOT covered under Medicare Part B? a. Cardiovascular disease scr...

AAPC CPB - Chapter 9 Questions and answers, graded A+ When a claim has been paid, an EOB is sent to: a. the clearinghouse. b. the patient. c. the provider. d. the insurance company. - -b. the patient. Cost based fee schedules are developed using which of the following: a. RBRVS methodology ...

CPB PRACTICE EXAM 1: Questions and answers, rated A+ ________________________ is a legal proceeding involving a person that is unable to repay outstanding outstanding debts. A. Collection Agency B. Bankruptcy C. Dismissal of patient D. Bad debt - -B. Bankruptcy According to Chapter 30 of t...

AAPC Chapter 1 CPB: Exam Review Questions and answers/ A physician received office space at a reduced rate for referring patients to the hospital's outpatient physical therapy center. What Law does this violate? 1. Anti-kickback Statute 2. Stark Law 3. False Claims Act 4. Truth in Lending ...

AAPC Chapter 1 CPB: Exam Review Questions and answers/ A physician received office space at a reduced rate for referring patients to the hospital's outpatient physical therapy center. What Law does this violate? 1. Anti-kickback Statute 2. Stark Law 3. False Claims Act 4. Truth in Lending ...

AAPC CPB Exam Review Questions and answers, rated A+ What is the term for the total amount of covered medical expenses a policyholder must pay each year out-of-pocket before the health insurance company begins to pay any benefits? - -A deductible is the amount a policyholder pays for health c...

AAPC CPB - Chapter 7 Review Questions and answers, rated A+ MUE is the acronym for: a. Medicare Unlikely Edits b. Medically Unnecessary Edits c. Medicare Unnecessary Edits d. Medically Unlikely Edits - -d. Medically Unlikely Edits Based on NCCI edits, when a procedure is bundled and has a CCM...

AAPC CPB - Chapter 14 Review: Questions and answers, rated A+ __________ sets standards and directives to protect workers against transmission of infectious agents. a. HIPAA b. JCAHO c. NCHS d. OSHA - -d. OSHA For OSHA, which employees are included as healthcare workers? I. medical staff I...

AAPC CPB - Chapter 8 Practical Application: Questions and answers, rated A+ Using the information in CPB Chapter 8 Case 1 to answer questions 1 and 2. After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect? I Date of birth II D...

CPB Chapter 12: BC/BS: Questions and answers, VERIFIED/ QUIZ - -QUIZ When a provider signs a contract to be a participating provider with an insurance payer they are agreeing to: a. Only see patients that are enrolled with that insurance company. b. Bill the patient for the total amount the ...

AAPC CPB - Chapter 10 Review Questions and answers, rated A+ Which statement is TRUE regarding the Prompt Payment Act? a. Patients are required to pay patient balances within 30 days. b. Patient balances are dismissed if a statement is not sent to the patient within 30 days. c. Federal agencies...

AAPC CPB - Chapter 4 Review Questions and answers, VERIFIED/ What is the ICD-10-CM code for a sore throat? a. J02.8 b. J02.0 c. J02.9 d. J31.2 - -c. J02.9 Patient is diagnosed with right bundle branch block. What ICD-10-CM code is reported? a. I45.10 b. I45.19 c. I45.5 d. I45.9 - -a. I45....

AAPC CPB - Chapter 12 Questions and answers, rated A+ Which type of insurance plan is a federal and state program that provides coverage to the low-income population? a. Medicare b. HMO c. Medicaid d. PPO - -c. Medicaid What is the correct action when a claim has been submitted to BCBS but...

AAPC CPB Chapter 1 Review Questions and answers, rated A+ FCA - -False Claims Act (FCA): {"knowing" and "knowingly"}-Federal statue setting civil and criminal penalties to protect the government from being overcharged or sold substandard goods or services: -falsely billing the government ...

AAPC CPB Chapter 11 Practical, Questions and answers, graded A+ Use CPB Chapter 11_Case to answer questions 1 & 2. After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect? I. The provider must accept assignment II. Provider name ...

AAPC CPB - Chapter 2 Questions and answers, rated A+ A patient presents to be seen in the office. He does not pay at the time the services are rendered as the provider is his primary care provider, or gatekeeper. The large group practice has 800 covered members under this plan as is paid on a...

AAPC CPB - Chapter 14 Questions and answers, rated A+ What type of state worker's compensation coverage allows an employer to set aside money to cover medical expenses and other related benefits for its employees? a. State insurance fund b. Self-insurance plans c. Commercial workers' compe...

AAPC CPB - Chapter 4 Questions and answers, rated A+ What is/are the correct code(s) for a patient with acute on chronic maxillary sinusitis? a. J01.00, J32.0 b. J01.00 c. J32.0, J01.00 d. J01.01 - -a. J01.00, J32.0 Which sections of ICD-10-CM does a biller use to code for a physician's off...

AAPC CPB Chapter 12 Practical Application/ Questions and answers, rated A+ Use CPB Chapter 12_Case to answer questions 1 and 2. After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect? I. Type of Insurance II. Primary insurance...

AAPC CPB - Chapter 13 Review Questions and answers, rated A+ On 05/02/19, a claim for a fine needle aspiration biopsy with ultrasound guidance was reported with CPT code 10022, ICD-10-CM code D49.2 for DOS 05/01/2019. Why would the claim be denied? a. Not medically necessary b. Invalid CPT cod...

AAPC CPB - CHAPTER 2: QUESTIONS & Answers, rated A+ Why must a provider obtain an NPI number? I. To submit claims II. To prove that he is licensed III. To be HIPAA compliant IV. To guarantee payment by a health plan a. I, II, III b. II, III, IV c. I, II, III, IV d. I, III - -d. I, III A ...

AAPC CPB - Chapter 9 Review Questions and answers, rated A+ A ______ indicates the location or type of service provided for an inpatient and is reported with _______. a. Revenue code; four-digit code b. Revenue code; three-digit code c. CPT code; five-digit code d. MSDRG code; three-digit co...

AAPC CPB - Chapter 10 Questions and answers, rated A+ What is the first step in working a denied claim? a. Resubmit the claim b. Contact the carrier c. Appeal the claim d. Determine and understand why the claim was denied - -d. Determine and understand why the claim was denied Which of the...

AAPC CPB Medical Billing Chapter 1 Intro to Healthcare, Questions and answers, rated A+ Stablization Act - 1942 - -1. Wages and price controls were placed on employers 2. Congress limited the wages that could be offered, but allowed the adoption of employee insurance plans Internal Revenue ...

CPB Chapter 9: Billing. Questions and answers, graded A+ QUIZ - -QUIZ Cost based fee schedules are developed using which of the following: a. RBRVS methodology b. total costs of every procedure or service listed in the CPT® c. total cost of all of the procedures the physician will perform d...

AAPC CPB - Chapter 4 Practical Application: Questions and answers. A patient was seen for a left ear infection. The provider diagnosed the patient with Swimmer's Ear in the left ear. The biller received a denial from XYZ Insurance Company stating H60.33 is an invalid diagnosis code. Why is t...

AAPC CPB - Chapter 9 Practical Application Questions and answers, VERIFIED/ Case 1 - Clearinghouse Rejections Report Status: 11/19/20XX Contents: C4450 - Principal Diagnosis Code must be valid; REJECTED BY SYSTEM EDI; Rejected Patient Name: Adams, David Patient Number: 384594 Payer: HEALTH...

AAPC CPB Chapter 1-5. Questions and answers, rated A+ Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination...

CPB CHAPTER 1 REVIEW Questions and answers, rated A+ ABUSE - -AN ACTION THAT RESULTS IN UNNECESSARY COSTS TO A FEDERAL HEALTHCARE PROGRAM, EITHER DIRECTLY OR INDIRECTLY CONDITIONS OF PARTICIPATION (CoP) - -CONDITIONS THAT HEALTHCARE ORGANIZATIONS MUST MEET IN ORDER TO PARTICIPATE WITH THE PL...

CPB Final Exam Review Questions and answers, rated A+ A female patient is covered by her employer and her husbands insurance plan. Which is primary? - - The patient's insurance because she is the primary subscriber. A hospital records transporter loses charts when they fall off the truck while...

CPB Chapter 1: Questions and answers, rated A+ An action that results in unnecessary costs to a federal healthcare program, either directly or indirectly? - -Abuse Knowingly and willfully offering or accepting rewards or remuneration for services that are billable to a federal healthcare pla...

CPB Exam Review Ch 8, Questions and answers, VERIFIED/ Adjudication - -Determination of the insurers payment amount after the members insurance benefits have been applied. Which Item on the CMS-1500 claim form contains information regarding Medigap? - -9, 9a, 9d What is the correct format to ...

CPB Chapter 2 Questions and answers, VERIFIED/ A group of primary care physicians has a contract with an HMO to provide care to enrollees.They have a patient in need of mental health services, for which the HMO pays on a fee-for-service basis as an exception to the normal contract. What is th...

AAPC CPB Chapter 2, Questions and answers, rated A+ Individual Health Plans - -Purchased by individuals, for themselves and/or their families +Not part of a group plan +Usually purchased by the self-employed or by those that are employed but are not offered group insurance by their employers ...

AAPC CPB Ch 2 exam review Questions and answers, VERIFIED/ What components make up the Medicare Physician Fee Schedule? Relative value units for physician work, practice expense, and professional liability insurance; the Geographical Practice Cost Index; and the conversion factor. Medicare us...

AAPC CPB Chapter 9 Review Questions and answers, verified/ A patient with ABC insurance is seen on May 1st, and the claim is submitted on July 15 of the same year. Has the claim met the timely filing deadline? a. Yes. All payers have the same timely filing deadline of one year from date of ser...

AAPC CPB - Chapter 7 Practical Application Questions and answers, verified/ Use CPB Chapter 7_Case to answer questions 1 & 2. A 40-year-old patient is trying Botox® for her chronic migraines. According to the policy, what are the symptom parameters that must be documented? a. The patient ...