Exam (elaborations)
CBCS practice test 2024/2025 graded A+
- Course
- Institution
CBCS practice test 2024/2025 graded A+
[Show more]
Content preview
CBCSpractice
test
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
-
ANSMedicaid
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
-
ANSAdjustment
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
-
ANSThe
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
-
ANSred
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
-
ANSUB-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
-
ANSThe
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
-
ANScoinsurance
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.
-
ANSthe
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
-
ANSprovider
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
-
ANS$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
-
ANSGuidelines
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
-
ANSBlock
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
-
ANSBlock
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
-
ANSInternal
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
-
ANSCommunicating
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
-
ANSHIPAA
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
-
ANSPatient
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.
-
ANSIt
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)
-
ANSDenied
-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
-
ANSInternal
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
-
ANSPatient
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
-
ANSAccounts
receivable
Which
of
the
following
is
considered
the
final
determination
of
the
issues
involving
settlement
of
an
insurance
claim?
-Processing
-Translation
-Adjudication
-Transmission
-
ANSAdjudication
(process
of
putting
a
claim
through
a
series
of
edits
for
final
determination)
-Processing
(
handling
a
claim
from
the
first
encounter
to
claim
submission)
-Translation
(claim
is
send
from
the
host
system
to
the
clearing
house)
-Transmission
(how
the
claim
was
sent)
Which
of
the
following
information
should
the
CBCS
input
into
block
33a
on
the
CMS-1500
claim
form
-Provider
social
security
number
(no
Social
security
number
on
CMS1500)
-Federal
tax
id
number
(entered
in
block
25)
-Patient
id
number
(on
block
1a)
-National
provider
identification
number
-
ANSNational
provider
identification
number
A
prospective
billing
account
audit
prevents
fraud
by
reviewing
and
comparing
a
completed
claim
form
with
which
of
the
following
documents?
-A
billing
worksheet
from
the
patient
account
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 Qualitydocs. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
81113 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now