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CPB Exam B Practice Questions and Answers (100% Pass)
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CPB Exam B Practice Questions and Answers (100% Pass) 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) coinsura...

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  • August 29, 2024
  • 26
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • cpb exam b practice questions and answers 100 pa

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©SOPHIABENNET@2024-2025 Thursday, August 22, 2024 10:21 AM




Certified Professional Biller By: American Academy of Professional Coders(AAPC)


CPB Exam B Practice Questions and
Answers (100% Pass)

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✔️✔️-Deductible

Which type of insurance covers physicians and other healthcare
professionals for liability as to claims arising from patient treatment?



A) Business liability

B) bonding

c) medical malpractice

d) workers' compensation - Answer✔️✔️-Medical malpractice




1

, ©SOPHIABENNET@2024-2025 Thursday, August 22, 2024 10:21 AM




Certified Professional Biller By: American Academy of Professional Coders(AAPC)


Which of the following does NOT fall under group policy insurance?



I. The premium is paid for by the employee.

II. The premium is paid for (or partially paid for) by an employer.

III. The employer selects the plan(s) to offer to employees.

IV. Physical exams and medical history questionnaires are a mandatory
part of the application process.

V. Employee can make changes to the policy.

VI. The employee's spouse and children are not eligible for coverage.



a) III, IV, V

b) II - IV

C) II, IV, V

D) I, IV, V, VI - Answer✔️✔️-I, IV, V, VI

Dr. Wallace is in a capitation contract with Belleview Managed Care Health
Plan.He received $25,000 from the health plan to provide services for the
175 enrollees on the health plan. The services provided by Dr. Wallace to
the enrollees cost $23,000. Based on the information, what must be done?




2

, ©SOPHIABENNET@2024-2025 Thursday, August 22, 2024 10:21 AM




Certified Professional Biller By: American Academy of Professional Coders(AAPC)




a) dr. wallace can keep the $2,000 profit under the terms of the capitated
plan

b) dr. wallace experienced a loss under the capitated plan and will need to
pay $2,000 to the health plan

c) dr. wallace will need to payout the $2,000 to the 175 enrollees.

d) dr. wallace is required to put the $2,000 in a mutual fund - Answer✔️✔️-
Dr. Wallace can keep the $2,000 profit under the terms of the capitated
plan.

What is the deadline for filing a Medicare claim?



a) one year from the date of service

b)30 days from the date of service

c) 90 days from the date of service

d) two years from the date of service - Answer✔️✔️-One year from the date
of service

A provider sees a patient who has TRICARE Standard. The provider is not
contracted with TRICARE but is certified by the regional TRICARE
Managed Care Support Contractor (MCSC). The provider charges $200 for



3

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