AAPC CPB - CHAPTER 2: QUESTIONS AND ANSWERS 100% PASS.
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Course
CPB
Institution
CPB
AAPC CPB - CHAPTER 2: QUESTIONS
AND ANSWERS 100% PASS.
Why must a provider obtain an NPI number?
I. To submit claims
II. To prove that he is licensed
III. To be HIPAA compliant
IV. To guarantee payment by a health plan
a. I, II, III
b. II, III, IV
c. I, II, III, IV
d. I, III - answerd. I,...
AAPC CPB - CHAPTER 2: QUESTIONS
AND ANSWERS 100% PASS.
Why must a provider obtain an NPI number?
I. To submit claims
II. To prove that he is licensed
III. To be HIPAA compliant
IV. To guarantee payment by a health plan
a. I, II, III
b. II, III, IV
c. I, II, III, IV
d. I, III - answer✔d. I, III
A patient has receipts for her dental cleaning, vision exam, and contact lenses. Her employer has
set up special accounts for each employee, there is no limit to the amount the employer can
contribute and the balances roll over from year to year. What type of account is this?
a. Flexible Spending Account (FSA)
b. Health Savings Account (HSA)
c. Health Insurance Account (HIA)
d. Traditional Healthcare Reimbursement Arrangement (HRA) - answer✔d. Traditional
Healthcare Reimbursement Arrangement (HRA)
A patient presents to be seen in the office. He does not pay at the time the services are rendered
as the provider is his primary care provider, or gatekeeper. The large group practice has 800
covered members under this plan as is paid on a monthly basis with a set amount that is based on
the number of members covered and their ages. What type of plan is this?
a. PPO
b. Capitation
c. Fee-for-service
d. Indemnity - answer✔b. Capitation
(Capitation payments are used by managed care organizations (MCOs) to control healthcare
costs by putting the physicians at financial risk for services provided to patients. Payments are
based on a per-person rate, rather than a fee-for-service rate.)
A family practitioner sees a Medicare patient and bills a 99213. This provider has opted-out of
Medicare. His fee for the service is $125.00. Medicare's approved amount is $73.08, and the
patient has met $0 of his deductible. What can the provider bill the patient?
a. $125.00
b. $73.08
c. $14.62
d. $58.46 - answer✔a. $125.00
(Providers that opt-out of Medicare are not limited to any specific charge limit on their patients.
The patient is responsible for payment in full for services as Medicare will not pay any amount
to either the patient or provider in this situation.)
What are the options for a provider with regards to participation with Medicare?
a. It is mandatory for every provider to participate in Medicare
b. Providers may participate, may choose not to participate, or may opt-out of Medicare
c. Providers are automatically opted-out
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