NHA CBCS Final Exam and Certified Billing and Coding Specialist (CBCS) Exam Questions And Answers With Solutions Package Deal 2024/2025
[Show more]
What describes the reason for a claim rejection because of Medicare NCCI edits - Improper code combinations A claim is submitted with a transposed insurance member ID number and returned to the provider. - Invalid Medigap coverage is offered to Medicare beneficiaries by whom - Private third- party p...
Preview 3 out of 16 pages
Add to cartWhat describes the reason for a claim rejection because of Medicare NCCI edits - Improper code combinations A claim is submitted with a transposed insurance member ID number and returned to the provider. - Invalid Medigap coverage is offered to Medicare beneficiaries by whom - Private third- party p...
When is the principle diagnosis applicable? - Inpatient Hospital coding The term "encounter records" means: - claim What is the name of the act designed to address the collection practices of third- party debt collectors and attorneys who regularly collect debts for others? - Fair debt colle...
Preview 3 out of 26 pages
Add to cartWhen is the principle diagnosis applicable? - Inpatient Hospital coding The term "encounter records" means: - claim What is the name of the act designed to address the collection practices of third- party debt collectors and attorneys who regularly collect debts for others? - Fair debt colle...
The symbol "O" in the Current Procedural Terminology reference is used to indicate what? - Reinstated or recycled code In the anesthesia section of the CPT manual, what are considered qualifying circumstances? - Add-on codes As of April 1, 2014 what is the maximum number of diagnoses that ca...
Preview 2 out of 13 pages
Add to cartThe symbol "O" in the Current Procedural Terminology reference is used to indicate what? - Reinstated or recycled code In the anesthesia section of the CPT manual, what are considered qualifying circumstances? - Add-on codes As of April 1, 2014 what is the maximum number of diagnoses that ca...
A nurse is reviewing a patients lab results prior to discharge and discovers an elevated glucose level. Which of the following health care providers should be altered before the nurse can proceed with discharge planning? - The attending physician On the CMS-1500 Claims for, blocks 14 through 33 con...
Preview 3 out of 20 pages
Add to cartA nurse is reviewing a patients lab results prior to discharge and discovers an elevated glucose level. Which of the following health care providers should be altered before the nurse can proceed with discharge planning? - The attending physician On the CMS-1500 Claims for, blocks 14 through 33 con...
A copay is the patient's share of the insurance premium. - False The term reconciliation means? - Determining how much the provider has been reimbursed and how much patient owes EOB (explanation of benefits) - Sent to policyholder RA (remittance advice) - Report from 3rd party payer to provide...
Preview 2 out of 11 pages
Add to cartA copay is the patient's share of the insurance premium. - False The term reconciliation means? - Determining how much the provider has been reimbursed and how much patient owes EOB (explanation of benefits) - Sent to policyholder RA (remittance advice) - Report from 3rd party payer to provide...
What describes the reason for a claim rejection because of Medicare NCCI edits - Improper code combinations A claim is submitted with a transposed insurance member ID number and returned to the provider. - Invalid Medigap coverage is offered to Medicare beneficiaries by whom - Private third- party p...
Preview 3 out of 16 pages
Add to cartWhat describes the reason for a claim rejection because of Medicare NCCI edits - Improper code combinations A claim is submitted with a transposed insurance member ID number and returned to the provider. - Invalid Medigap coverage is offered to Medicare beneficiaries by whom - Private third- party p...
When a billing and coding specialist is completing the CMS-1500 claim form, which of the following information is required to process a medical claim? - CPT, ICD The allowed amount for a patient's office visit is $175. The copayment is $15 and the amount the insurance paid is $85. Which of the f...
Preview 2 out of 11 pages
Add to cartWhen a billing and coding specialist is completing the CMS-1500 claim form, which of the following information is required to process a medical claim? - CPT, ICD The allowed amount for a patient's office visit is $175. The copayment is $15 and the amount the insurance paid is $85. Which of the f...
A patient presents to the provider with chest pain and shortness of breath. After an unexpected ECG result, the provider calls a cardiologist and summarizes the patient's symptoms. What portion of HIPAA allows the provider to speak to the cardiologist prior to obtaining the patient's consent? ...
Preview 2 out of 9 pages
Add to cartA patient presents to the provider with chest pain and shortness of breath. After an unexpected ECG result, the provider calls a cardiologist and summarizes the patient's symptoms. What portion of HIPAA allows the provider to speak to the cardiologist prior to obtaining the patient's consent? ...
Medical Billing & Coding as a Career - *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Bill...
Preview 4 out of 39 pages
Add to cartMedical Billing & Coding as a Career - *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Bill...
Medical Billing & Coding as a Career - *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Bill...
Preview 4 out of 38 pages
Add to cartMedical Billing & Coding as a Career - *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Bill...
Missing #1 - blank A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - Invalid. Medigap coverage is offered to Medicare beneficiaries by? - Private Third-party payers This pr...
Preview 2 out of 8 pages
Add to cartMissing #1 - blank A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - Invalid. Medigap coverage is offered to Medicare beneficiaries by? - Private Third-party payers This pr...
what do physicians use to electronically submit claims? - clearinghouse what is one purpose of an internal auditing program in a physician's office? - verifying that the medical records and the billing records match in which department should a patient be seen for psoriasis - dermatology * on a...
Preview 2 out of 10 pages
Add to cartwhat do physicians use to electronically submit claims? - clearinghouse what is one purpose of an internal auditing program in a physician's office? - verifying that the medical records and the billing records match in which department should a patient be seen for psoriasis - dermatology * on a...
1. Missing #1 - BLANK 2. A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - INVALID 3. Medigap coverage is offered to Medicare beneficiaries by? - PRIVATE THIRD- PARTY PAYER ...
Preview 2 out of 13 pages
Add to cart1. Missing #1 - BLANK 2. A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - INVALID 3. Medigap coverage is offered to Medicare beneficiaries by? - PRIVATE THIRD- PARTY PAYER ...
Medical Billing and Coding Certification Blocks 14 through 33 - The patient's condition and the provider's information are shown in what blocks in CMS 1500 form? Coding Compliance Plan - Which of the following includes procedures and best practices for correct coding? Use Arial size 10 font -...
Preview 3 out of 21 pages
Add to cartMedical Billing and Coding Certification Blocks 14 through 33 - The patient's condition and the provider's information are shown in what blocks in CMS 1500 form? Coding Compliance Plan - Which of the following includes procedures and best practices for correct coding? Use Arial size 10 font -...
Which of the following is considered the final determination of the issues involving settlement of an insurance claim? - Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information is called which of the following? - Encounter form A patient comes to the hosp...
Preview 3 out of 18 pages
Add to cartWhich of the following is considered the final determination of the issues involving settlement of an insurance claim? - Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information is called which of the following? - Encounter form A patient comes to the hosp...
Which of the following electronic forms is used to post payments? - Electronic remittance advice (ERA) If a clean claim is received March 1 of this year, which of the following is the allowable last day of payment in order to meet Medicare compliance requirements? - March 30 Threading a cathete...
Preview 2 out of 9 pages
Add to cartWhich of the following electronic forms is used to post payments? - Electronic remittance advice (ERA) If a clean claim is received March 1 of this year, which of the following is the allowable last day of payment in order to meet Medicare compliance requirements? - March 30 Threading a cathete...
Requires documentation of the patient's informed consent. - urine pregnancy The patient should for a 24-hour urine specimen. - discard the first urine sample prior to collection 20/50 with no errors on the Snellen test means: - The patient can see at 20 feet what the normal eye sees at 50 feet....
Preview 2 out of 6 pages
Add to cartRequires documentation of the patient's informed consent. - urine pregnancy The patient should for a 24-hour urine specimen. - discard the first urine sample prior to collection 20/50 with no errors on the Snellen test means: - The patient can see at 20 feet what the normal eye sees at 50 feet....
A would be the provider who would perform means the amount of reimbursement an insurance payer and patient agrees to pay a provider. - ALLOWED AMOUNT The appendix is located in the of the The investigates cases of fraud and prepares a referral for prosecution. - OFFICE OF THE INSPECTOR GENERAL A...
Preview 2 out of 12 pages
Add to cartA would be the provider who would perform means the amount of reimbursement an insurance payer and patient agrees to pay a provider. - ALLOWED AMOUNT The appendix is located in the of the The investigates cases of fraud and prepares a referral for prosecution. - OFFICE OF THE INSPECTOR GENERAL A...
Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - Yes According to The Joint Commission, who may amend medical staff bylaws? - Medical Staff Failure to meet the established qualifications and criteria for appointment should be reported to ...
Preview 2 out of 9 pages
Add to cartAre limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - Yes According to The Joint Commission, who may amend medical staff bylaws? - Medical Staff Failure to meet the established qualifications and criteria for appointment should be reported to ...
What two accreditors state: a hospital may not rely solely on board certification when considering practitioner for medical staff membership? - HFAP, CMS According to JC & HFAP name four approved sources PSV for Medical Education - Medical School, AMA, ECFMG, AOA According to NCQA practitioners mus...
Preview 3 out of 25 pages
Add to cartWhat two accreditors state: a hospital may not rely solely on board certification when considering practitioner for medical staff membership? - HFAP, CMS According to JC & HFAP name four approved sources PSV for Medical Education - Medical School, AMA, ECFMG, AOA According to NCQA practitioners mus...
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
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!
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
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.
Stuvia is a marketplace, so you are not buying this document from us, but from seller shadow251. Stuvia facilitates payment to the seller.
No, you only buy these notes for $40.00. You're not tied to anything after your purchase.
4.6 stars on Google & Trustpilot (+1000 reviews)
82215 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now