NHA CBCS Exam Prep Questions and Answers Graded A 2024
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What actions should be taken when a claim is billed for a level four office visit and paid at a level three? -Answer- Submit an appeal with documentation
The standard medical abbreviation "ECG" refers to a test used to assess which of the body systems? -Answer- cardiovascular system- test checks...
NHA CBCS Exam Prep Questions and
Answers Graded A 2024
What actions should be taken when a claim is billed for a level four office visit and paid
at a level three? -Answer- ✔Submit an appeal with documentation
The standard medical abbreviation "ECG" refers to a test used to assess which of the
body systems? -Answer- ✔cardiovascular system- test checks electricity of heart
According to HIPAA standards, what identifies the rendering provider on the CMS-1500
claim form in Block 24J? -Answer- ✔NPI
On the CMS-1500 claim form, blocks 14 through 33 contain information about? -
Answer- ✔The patient's condition and the provider's information
Which block should the BCS complete on the CMS-1500 form for procedures, services,
or supplies? -Answer- ✔24D
Which term describes when a plan pays 70% of the allowed and the patient pays 30%?
-Answer- ✔Coinsurance is a percentage of the cost for covered services that is
approved by the insurance company
A provider charges $500 to a claim that had an allowable amount of $400. What should
happen to the non-allowed charge? -Answer- ✔Write Off or adjustment
Patient: Justin Austin; Social Security NO.: 555-22-1111; Medicare ID NO.: 555-33-
2222A; DOB: 05/22/1945. Claim information entered: Austin, Jane; Social Security No.:
555-22-111; Medicare ID No.: 555-33-2222A; DOB: 052245. What is a reason the claim
was rejected? -Answer- ✔The DOB is entered incorrectly - the format is two digits for
the month and four digits for the year.
A patient's health plan is referred to as the "payer of last resort." The patient is covered
by which health plan? -Answer- ✔Medicaid
The physician bills $500 to a patient. After submitting the claim to the insurance
company, the claim is sent back with no payment. The patient still owes $500 for the
year. This amount is called what? -Answer- ✔Deductible
Ambulatory surgery centers, home health care, and hospice organizations use what
form? -Answer- ✔UB-04 Form
A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has
Medicare as her primary insurance. Which form is required so the patient knows she
NHA CBCS Exam
, NHA CBCS Exam
may be responsible for payment? -Answer- ✔Advanced Beneficiary Notice is a form that
is required for Medicare recipients
Which of the following should the BCS complete to be reimbursed for the provider's
services? -Answer- ✔CMS-1500 claim form
What is the maximum number of diagnoses that can be reported on the CMS-1500
claim form before a further claim is required? -Answer- ✔12
Describe a delinquent claim? -Answer- ✔It is considered delinquent when it is overdue
for payment, 120 days or older
What are considered proper supportive documentation for reporting CPT and ICD codes
for surgical procedures? -Answer- ✔Operative reports are required to support surgical
procedures
When submitting a clean claim with a diagnosis of kidney stones, which of the following
procedure names is correct? -Answer- ✔Nephrolithiasis The destruction of kidney
stones
The BCS should first divide the e/m code by which of the following? -Answer- ✔Place of
service which narrows down the specific code as one of the three deciding factors
Appeal the decision with a provider's report -Answer- ✔Which of the following actions
should be taken if an insurance company denies a service as not medically necessary?
Which departments should a patient be seen for psoriasis? And what body system is
involved? -Answer- ✔Dermatology, related to the integumentary system which includes
hair, skin, and nails
Which block requires the patient's authorization to release medical information to
process a claim? -Answer- ✔Block 12
What is the purpose of precertification? -Answer- ✔Verification of Coverage
A provider performs an examination of a patient's sore throat during an office visit. What
describes the level of the examination? -Answer- ✔Problem-focused examination is a
specific examination of an affected organ.
What is the verbal or written agreement that gives approval to some action, situation, or
statement, and allows the release of patient information? -Answer- ✔Consent
agreement
NHA CBCS Exam
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