Exam (elaborations)
AAPC CPB - Practice Exam A/41 Questions & Answers
- Course
- Institution
AAPC CPB - Practice Exam A/41 Questions & Answers
[Show more]
Seller
Follow
Victorious23
Reviews received
Content preview
AAPC CPB - Practice Exam A/41 Questions &Answers
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.
B. Mary, because her date of birth is the 4th and Joe's date of birth is the
23rd.
C. Mary, because her birth year is before Joe's birth year.
D. Joe, because his birth month and day are before Mary's birth month and
day. - -D. Joe, because his birth month and day are before Mary's birth
month and day.
-Which type of managed care insurance allows patients to self-refer to out-
of-network providers and pay a higher co-insurance/copay amount?
I. HMO
II. PPO
III. EPO
IV. POS
V. Capitation
A. II
B. IV
C. II and IV
D. II, III, and V - -C. II and IV
-A patient covered by a PPO is scheduled for knee replacement surgery. The
biller contacts the insurance carrier to verify benefits and preauthorize the
procedure. The carrier verifies the patient has a $500 deductible which must
be met. After the deductible, the PPO will pay 80% of the claim. The
contracted rate for the procedure is $2,500. What is the patient's
responsibility?
A. $400
B. $500
C. $900
D. $1,600 - -C. $900
-When a nonparticipating provider files a claim for a patient to BC/BS, how is
the payment processed?
, A. The payment is sent to the patient and the patient must pay the provider.
B. The payment is sent to the provider if the provider agrees to accept
assignment.
C. The payment is sent to the provider regardless if he accepts assignment.
D. The claim is not paid because the provider is not participating in the plan.
- -A. The payment is sent to the patient and the patient must pay the
provider.
-Which of the following TRICARE options is/are available to active duty
service members?
A. TRICARE Select
B. TRICARE Prime
C. TRICARE For Life
D. TRICARE Young Adult - -B. TRICARE Prime
-A Medicare card will list which of the following:
I. Effective date of coverage
II. Home address
III. Telephone Number
IV. Entitled to Part A and/or Part B
V. When coverage ends
VI. Name of Primary Care Physician
A. I - VI
B. I, IV
C. I-III, VI
D. I, II, IV, V - -B. I, IV
-In which of the following scenarios is Medicare the secondary payer?
I. A 65 year-old patient who is collecting her deceased spouse's Medicare
benefits and has a supplemental insurance
II. A 72 year-old patient who participates in the group health insurance of his
employer
III. A 66 year-old patient is injured at work and the employer does not offer
health insurance as a benefit of employment
IV. A 55 year-old patient who is on disability through Social Security and
qualifies for Medicaid and Medicare
A. I-IV
B. II and III
C. I and IV
D. None - -B. II and III
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 or Stuvia-credit 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 $10.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79271 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now