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AAPC CPB - CHAPTER 9 REVIEW
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AAPC CPB - CHAPTER 9 REVIEW
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AAPC CPB - CHAPTER 9 REVIEWA ______ indicates the location or type of service provided for an inpatient and is
reported with _______.
a. Revenue code; four-digit code
b. Revenue code; three-digit code
c. CPT code; five-digit code
d. MSDRG code; three-digit code - Answers -a. Revenue code; four-digit code
Which of the following documentation is NOT needed for an audit?
a. Encounter form
b. Medical record
c. Explanation of Benefits
d. CMS-1500 claim form - Answers -c. Explanation of Benefits
A clearinghouse is an entity that provides which of the following services?
a. Converts nonstandard data received from payers to standard transaction data to
meet HIPAA requirements.
b. Pursues payments of debts owed by individuals or businesses.
c. Assists providers in the collection of appropriate reimbursement for services
rendered.
d. Explains insurance benefits, policy requirements, and filing rules to patients. -
Answers -a. Converts nonstandard data received from payers to standard transaction
data to meet HIPAA requirements.
Which is a TRUE statement about daily deposits?
a. Keeping the checks and cash in the office for more than a day opens the practice up
to liability for the cash and checks.
b. Daily deposits should be made for the mail receipts and personal payment receipts.
c. Daily deposits of the mail receipts and personal payment receipts should be balanced
each day.
d. All the statements are true. - Answers -d. All the statements are true.
Mrs. Fryer takes her son to the ED for an injured arm. Her son is covered by both
parents. Mr. Fryer's birthday is 10/14/1984 and Mrs. Fryer's birthday is 6/10/1986.
Under the birthday rule whose insurance plan will be primary?
a. Mrs. Fryer
b. Mr. Fryer
c. Either one can be primary
d. The parent's birthday closest to the child's birthday - Answers -a. Mrs. Fryer
, When a batch of claims is submitted electronically to a clearinghouse a report is sent to
the provider. Which feedback does this report from the clearinghouse identify?
a. Shows improper Medicare payments paid to the provider.
b. Patient claims that will be sent to collections.
c. All claims sent to the payer and all rejected claims.
d. Patient claims that have not been paid within a certain time frame. - Answers -c. All
claims sent to the payer and all rejected claims.
What is a clean claim?
a. A blank claim form
b. A claim that meets medical necessity
c. A claim that has all of the information required to be processed
d. A claim that is paid on time - Answers -c. A claim that has all of the information
required to be processed
When creating a fee schedule for a practice, which of the following can be used to set
the fees?
a. National Correct Coding Initiatives (NCCI)
b. Local Coverage Determination (LCD)
c. Current Procedural Terminology (CPT®)
d. Relative Value Units (RVU) - Answers -d. Relative Value Units (RVU)
Payments due from patients, payers, or other guarantors that are owed to the practice
for services rendered are considered
a. Collections
b. Bad Debt
c. Accounts Receivable
d. None of the above - Answers -c. Accounts Receivable
Which of the following can be done to reduce payment delay?
a. Verify patient's insurance information on each patient visit.
b. Submit a paper and electronic claim for a patient's visit.
c. Wait for the clearinghouse to send you a status report.
d. Always submit medical record documentation with every claim. - Answers -a. Verify
patient's insurance information on each patient visit.
Which regulation established claim standards for electronic filing requirements when a
provider uses a computer with software to submit an electronic claim?
a. Health Insurance Portability and Accountability Act (HIPAA)
b. Affordable Care Act (ACA)
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