CPB Certified Professional Biller Certification Bundle Set

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 billing? A. Joe, because he is the male head of the household. ...

Health plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a: Answer covered entity Which of the following is not a covered entity in the Privacy Rule Answer healthcare consulting firm A request for medical records is received for a spec...

Abuse Answer Actions inconsistent with accepted, sound medical business or fiscal practice Accept Assignment Answer Provider accepts as payment in full whatever is paid on the cliam by the payer (except for any copayment and or coinsurance amounts.) Accounts Receivable Answer The amount owed t...

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 which to focus collection efforts? Answer workers' compensa...

EPO Answer ...provides benefits to subscribers who are required to receive services from network providers IDS Answer ...organizations of affiliated providers sites that offer joint healthcare services to subscribers HMO Answer ...providers comprehensive healthcare services to voluntarily enro...

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. Copayment B. Deductible C. Secondary Payment D. Coinsurance Answer B. Deductible Which type of insurance c...

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? Answer Qui Tam In which of the following circumstances may ...

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? Answer A deductible is the amount a policyholder pays for health care services before the health insurance begins to pay. ...

What does the acronym PHI stand for? a. Patient Healthcare Information b. Patient History of Illness c. Protected Health Information d. Protected Healthcare Index Answer c. Protected Health Information A new radiology company opens in town. The manager calls your practice and offers to pay ...

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 policy number III. Primary group number IV. Federal Tax ID number V. Billi...