CPB Certification Exam Prep (based off
Practice Exam #2) Questions And Answers
100% Pass.
What organization is responsible in evaluating the medical necessity, appropriateness, and
efficiency of the use of healthcare services and procedures?
A. Utilization Review Organization
B. Managed Care Organization
C. Quality Assurance Organization
D. External Quality, Review, Organization - answer✔A. Utilization Review Organization
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) 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. The employee's spouse and children are not eligible for coverage.
A. I, IV, V, and VI
B. II, III, and VI
C. II, IV, and V
When a minor procedure is performed on a Medicare patient, what is the global period and what
time frame is covered?
A. 90-day global period - the day before the procedure and 90 days following the procedures.
B. 10-day global period - the day of the procedure and 10 days following the procedure.
C. 10-day global period - the day before the procedure and 10 days following the procedure.
D. 90-day global period - the day of the procedure and 90 days following the procedure. -
answer✔B. 10-day global period - the day of the procedure and 10 days following the procedure.
Which of the following falls under the Prompt Payment Act?
A. Clean claims must be paid or denied within 30 days from the date of receipt by MACs.
B. Penalty fees will only be issued on clean claims if payments are 60 days overdue starting the
day after the receipt date.
C. Medicare and MACs have 60 days to pay or deny electronic clean claims.
D. Physician needs to refund overpayments within 30 days to the Medicare Administrative
Contractor (MAC) from the date of receipt. - answer✔A. Clean claims must be paid or denied
within 30 days from the date of receipt by MACs.
What is the Prompt Payment Act? - answer✔Requires federal agencies, such as MACs to pay or
deny clean claims (also electronic claims) within 30 days from receipt.
What is another term for balance billing?
A. Surprise medical bill
B. Medicare bill
C. Unauthorized bill
D. Clean bill - answer✔A. Surprise medical bill
What is balance billing? - answer✔Billing patients for Medicaid covered services.
Medical providers are forbidden by law to:
A. Refer patients to specialists
B. Balance bill patients
C. Bill patients for non-covered services
D. Accept co-payments - answer✔B. Balance bill patients
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