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Exam (elaborations)

NHA CBCS CERTIFICATION 2024/2025 graded A+

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  • Module
  • NHA - Certified Billing And Coding Specialist
  • Institution
  • NHA - Certified Billing And Coding Specialist

NHA CBCS CERTIFICATION 2024/2025 graded A+

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  • March 8, 2024
  • 14
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers
  • NHA - Certified Billing And Coding Specialist
  • NHA - Certified Billing And Coding Specialist

1  review

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By: amanekirtz • 3 weeks ago

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By: Qualitydocs • 3 weeks ago

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NHA
CBCS
CERTIFICA TION
Which
of
the
following
is
considered
the
final
determination
of
the
issues
involving
settlement
of
an
insurance
claim?
-
ANSAdjudication
A
form
that
contains
charges,
DOS,
CPT
codes,
ICD
codes,
fees
and
copayment
information
is
called
which
of
the
following?
-
ANSEncounter
form
A
patient
comes
to
the
hospital
for
an
inpatient
procedure.
Which
of
the
following
hospital
staff
members
is
responsible
for
the
initial
patient
interview,
obtaining
demographic
and
insurance
information,
and
documenting
the
chief
complaint?
-
ANSAdmitting
clerk
Which
of
the
following
privacy
measures
ensures
protected
health
information
(phi)?
-
ANSUsing
data
encryption
software
on
office
workstations
Which
of
the
following
planes
divides
the
body
into
left
and
right?
-
ANSSagittal
Which
of
the
following
provisions
ensures
that
an
insured's
benefits
from
all
insurance
companies
do
not
exceed
100%
of
allowable
medical
expenses?
-
ANSCoordination
of
benefits
Which
of
the
following
actions
should
be
taken
first
when
reviewing
a
delinquent
claim?
-
ANSVerify
the
age
of
the
account
Which
of
the
following
is
the
advantage
of
electronic
claim
submission?
-
ANSClaims
are
expedited
Which
of
the
following
components
of
an
explanation
of
benefits
expedites
the
process
of
a
phone
appeal?
-
ANSClaim
control
number
The
standard
medical
abbreviation
ECG
refers
to
a
test
used
to
assess
which
of
the
following
body
systems?
-
ANSCardiovascular
system
Which
of
the
following
actions
by
a
billing
and
coding
specialist
would
be
considered
fraud?
-
ANSBilling
for
services
not
provided
The
><
symbol
is
used
to
indicate
a
new
and
revised
test
other
than
which
of
the
following?
-
ANSProcedure
descriptors
On
the
CMS-1500
claim
form,
blocks
14
through
33
contain
information
about
which
of
the
following?
-
ANSThe
patient's
condition
and
the
provider's
information
Which
of
the
following
includes
procedures
and
best
practices
for
correct
coding?
-
ANSCoding
Compliance
Plan When
completing
a
CMS-1500
paper
claim
form,
which
of
the
following
is
an
acceptable
action
for
the
billing
and
coding
specialist
to
take?
-
ANSUse
arial
size
10
font
A
participating
blue
cross/blue
shield
(BC/BS)
provider
receives
an
explanation
of
benefits
for
a
patient
account.
The
charged
amount
was
$100.
BC/BS
allowed
$80
and
applied
$40
to
the
patient's
annual
deductible.
BC/BS
paid
the
balance
at
80%.
How
much
should
the
patient
expect
to
pay?
-
ANS$48
Which
of
the
following
indicates
a
claim
should
be
submitted
on
paper
instead
of
electronically?
-
ANSThe
claim
requires
an
attachment
According
to
HIPAA
standards,
which
of
the
following
identifies
the
rendering
provider
on
the
CMS-1500
claim
form
in
block
24j?
-
ANSNPI
Which
of
the
following
blocks
should
the
billing
and
coding
specialist
complete
on
the
CMS-1500
claim
form
form
for
procedures,
services
or
supplies
(CPT/HCPCS)?
-
ANSBlock
24D
Which
of
the
following
terms
describes
when
a
plan
pays
70%
of
the
allowed
amount
and
the
patient
pays
30%?
-
ANSCoinsurance
A
provider
charged
$500
to
claim
that
had
an
allowable
amount
of
$400.
In
which
of
the
following
columns
should
the
billing
and
coding
specialist
apply
the
non-allowed
charge?
-
ANSAdjustment
column
of
the
credits
Which
of
the
following
is
a
HIPAA
compliance
guideline
affecting
electronic
health
records?
-
ANSThe
electronic
transmission
and
code
set
standards
require
every
provider
to
use
the
healthcare
transactions
,code
sets
and
identifiers
Patient:
Jane
Austin;
Social
Security
#
555-22-1111;
Medicare
ID:
555-33-2222A;
DOB:
05/22/1945.
Claim
information
entered:
Austin,
Jane;
Social
Security
#.:
555-22-1111;
Medicare
ID
No.:
555-33-2222A;
DOB:
052245.
Which
of
the
following
is
a
reason
this
claim
was
rejected?
-
ANSThe
DOB
is
entered
incorrectly
Why
does
correct
claim
processing
rely
on
accurately
completed
encounter
forms?
-
ANSThey
streamline
patient
billing
by
summarizing
the
services
rendered
for
a
given
date
of
service
A
patient's
health
plan
is
referred
to
as
the
"payer
of
last
resort."
The
patient
is
covered
by
which
of
the
following
health
plans?
-
ANSMedicaid
Which
of
the
following
color
formats
is
acceptable
on
the
CMS-1500
claim
form?
-
ANSRed
Which
of
the
following
is
an
example
of
a
violation
of
an
adult
patient's
confidentiality?
-
ANSPatient
information
was
disclosed
to
the
patient's
parents
without
consent.
In
the
anesthesia
section
of
the
CPT
manual,
which
of
the
following
are
considered
qualifying
circumstances?
-
ANSAdd-on
codes

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