Exam (elaborations)
CBCS practice test/254 Complete Questions with Answers
CBCS practice test/254 Complete Questions with Answers
[Show more]
Content preview
CBCS practice test/254 CompleteQuestions with Answers
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?
Medicaid
CHAMPA
Medicare
TRICARE - -Medicaid
-A provider charged $500 to a claim that had an allowable amount of $400.
In which of the following columns should the CBCS apply the non allowed
charge?
-Reference column (For notations)
-Description column
-Payment column
-Adjustment column of the credits - -Adjustment column of the credits
-Which of the following statements is correct regarding a deductible?
-Coinsurance is a type of deductible
-The physician should write off the deductible
-The insurance company pays for the deductible
-The deductible is the patient's responsibility - -The deductible is the
patient's responsibility
-Which of the following color formats allows optical scanning of the CMS-
1500 claim form?
-Red
-Blue
-Green
-black - -red
-Ambulatory surgery centers, home health and hospice organizations use
the ______.
-CMS-1500 claim form
-UB-04 claim form
-Advance Beneficiary notice
-First report of injury form - -UB-04
-Claims that are submitted without an NPI number will delay payment to the
provider because ______.
-The number is the patient' id number
-The number is needed to identify the provider
-Is is used as a claim number
,-It is used as a pre authorization number - -The number is needed to identify
the provider
-Which of the following terms describes when a plan pays 70% of the
allowed amount and the patient pays 30%?
-Coinsurance
-Deductible
-Premium
-copayment - -coinsurance
-Which of the following indicates a claim should be submitted on paper
instead of electronically?
-The software claims review process indicates the claim is not complete
-The claim needs authorization
-The claim requires an attachment
-The practice management software is non functional. - -the claim requires
an attachment
-On a remittance advice form, which of the following is responsible for
writing off the difference between the amount billed and the amount allowed
by the agreement?
-Provider
-Insurance company
-Patient
-Third party payer - -provider
-A physician is contracted with an insurance company to accept the amount.
The insurance company allows $80 of a $120 billed amount, and $50 of the
deductible has not been met. How much should the physician write off the
patient's account?
-$40
-$15
-$0
-$50 - -$40
-The unlisted codes can be found in which of the following locations in the
CPT manual?
-Appendix L
-Guidelines prior to each section
-End of each body system
-Table of contents - -Guidelines prior to each section
-Which of the following blocks should the billing and coding specialist
complete the CMS 1500 claims form for procedure, services or supplies?
-Block 12
-Block 2
,-Block 24D
-Block 24J - -Block 24D
-Block 12 (patient's authorization block
-Block 2 ( patient's name)
-Block 24J ( for the rendering provider)
-Which of the following blocks requires the patient's authorization to release
medical information to process a claim?
Block 12
Block 13
Block 27
Block 31 - -Block 12
- Block 13 patient authorization for benefits required for third party payer
- Block 27 accepting assignment of benefits
- Block 31 (treating physician)
-Which of the following steps would be part of a physician's practice
compliance program?
-HIPAA compliance audit
-Physician recruitment
-Internal monitoring and auditing
-Notice of privacy practice - -Internal monitoring and auditing
-Behavior plays an important part of being a team player in a medical
practice. Which of the following is an appropriate action for the CBCS to
take?
-Reprimanding another staff member during a team meeting for displaying a
bad attitude toward a patient
-Looking in the medical record of a friend who receives services at the office
-Communicating with the front desk staff during a team meeting about
missing information in patient files
-Questioning the nurse about the provider documentation in the medical
record - -Communicating with the front desk staff during a team meeting
about missing information in patient files
-Which of the following acts applies to the administrative simplification
guideline?
-HIPAA
-Deficit reduction act of 2005
-The patient protection and affordable care act 2009
-National correct coding initiative of 1995 - -HIPAA
-Which of the following is an example of a violation of an adult patient's
confidentiality?
-While reviewing a claim, the CBCS reads the diagnosis before realizing that
the patient is a neighbor
, -A CBCS queries the physician about a diagnosis in a patient's medical record
-The physician uses his home phone to discuss patient care with the nursing
staff
-Patient information was disclosed to the patient's parents without consent -
-Patient information was disclosed to the patient's parents without consent
-Which of the following is the purpose of running an aging report each
month?
-If indicates the balances the patients owe the provider
-It indicates which patients have upcoming or missed appointment
-It indicates which claims are outstanding
-It indicates what the insurance company has paid for the provider's services
to a patient. - -It indicates which claims are outstanding
-Which of the following describes the status of a claim that does not include
the required preauthorization for a service?
-Delinquent (overdue)
-Denied
-Suspended
-Adjudicated (claim still being processed) - -Denied
-Delinquent (overdue)
-Adjudicated (claim still being processed)
-Which of the following actions should the CBCS take to prevent fraud and
abuse in the medical office?
-Serviced procedure preauthorization
-Internal monitoring and auditing
-Utilization review
-Correct coding initiative - -Internal monitoring and auditing
-In an outpatient setting, which of the following forms is used as a financial
report of all services provided to patients?
-Encounter form
-Patient account record
-CMS-1500 claim form
-Accounts receivable journal - -Patient account record (patient ledger, all
transactions between patient and the practice)
-Accounts receivable journal (Day sheet = chronological summary of all
transaction on a specific day)
-Patient charges that have not been paid will appear in which of the
following?
-Accounts receivable
-Accounts payable
-Tracer
-Rejected claim - -Accounts receivable
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Victorious23. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for £16.61. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
81989 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy revision notes and other study material for 14 years now