NHA CBCS CERTIFICATION EXAM AND PRACTICE EXAM NEWEST
2024-2025 ACTUAL EXAM COMPLETE 211 QUESTIONS AND CORRECT
DETAILED ANSWERS
Study online at https://quizlet.com/_frlgbn
1. Which of the following is considered the final de- Adjudication
termination of the issues involving settlement of an
insurance claim?
2. A form that contains charges, DOS, CPT codes, ICD Encounter form
codes, fees and copayment information is called
which of the following?
3. A patient comes to the hospital for an inpatient proce- Admitting clerk
dure. Which of the following hospital staff members is
responsible for the initial patient interview, obtaining
demographic and insurance information, and docu-
menting the chief complaint?
4. Which of the following privacy measures ensures Using data en-
protected health information (phi)? cryption software
on office worksta-
tions
5. Which of the following planes divides the body into Sagittal
left and right?
6. Which of the following provisions ensures that an Coordination of
insured's benefits from all insurance companies do benefits
not exceed 100% of allowable medical expenses?
7. Which of the following actions should be taken first Verify the age of
when reviewing a delinquent claim? the account
8. Which of the following is the advantage of electronic Claims are expe-
claim submission? dited
9. Which of the following components of an explanation Claim control
of benefits expedites the process of a phone appeal? number
10. The standard medical abbreviation ECG refers to a Cardiovascular
test used to assess which of the following body sys- system
tems?
, NHA CBCS CERTIFICATION EXAM AND PRACTICE EXAM NEWEST
2024-2025 ACTUAL EXAM COMPLETE 211 QUESTIONS AND CORRECT
DETAILED ANSWERS
Study online at https://quizlet.com/_frlgbn
11. Which of the following actions by a billing and coding Billing for services
specialist would be considered fraud? not provided
12. The >< symbol is used to indicate a new and revised Procedure de-
test other than which of the following? scriptors
13. On the CMS-1500 claim form, blocks 14 through 33 The patient's con-
contain information about which of the following? dition and the
provider's infor-
mation
14. Which of the following includes procedures and best Coding Compli-
practices for correct coding? ance Plan
15. When completing a CMS-1500 paper claim form, Use arial size 10
which of the following is an acceptable action for the font
billing and coding specialist to take?
16. A participating blue cross/blue shield (BC/BS) $48
provider receives an explanation of benefits for a pa-
tient account. The charged amount was $100. BC/BS
allowed $80 and applied $40 to the patient's annu-
al deductible. BC/BS paid the balance at 80%. How
much should the patient expect to pay?
17. Which of the following indicates a claim should be The claim requires
submitted on paper instead of electronically? an attachment
18. According to HIPAA standards, which of the following NPI
identifies the rendering provider on the CMS-1500
claim form in block 24j?
19. Which of the following blocks should the billing Block 24D
and coding specialist complete on the CMS-1500
claim form form for procedures, services or supplies
(CPT/HCPCS)?
20. Coinsurance
, NHA CBCS CERTIFICATION EXAM AND PRACTICE EXAM NEWEST
2024-2025 ACTUAL EXAM COMPLETE 211 QUESTIONS AND CORRECT
DETAILED ANSWERS
Study online at https://quizlet.com/_frlgbn
Which of the following terms describes when a plan
pays 70% of the allowed amount and the patient pays
30%?
21. A provider charged $500 to claim that had an al- Adjustment col-
lowable amount of $400. In which of the following umn of the credits
columns should the billing and coding specialist ap-
ply the non-allowed charge?
22. Which of the following is a HIPAA compliance guide- The electron-
line affecting electronic health records? ic transmission
and code set
standards require
every provider to
use the healthcare
transactions ,code
sets and identi-
fiers
23. Patient: Jane Austin; Social Security # 555-22-1111; The DOB is en-
Medicare ID: 555-33-2222A; DOB: 05/22/1945. Claim tered incorrectly
information entered: Austin, Jane; Social Security #.:
555-22-1111; Medicare ID No.: 555-33-2222A; DOB:
052245. Which of the following is a reason this claim
was rejected?
24. Why does correct claim processing rely on accurately They streamline
completed encounter forms? patient billing by
summarizing the
services rendered
for a given date of
service
25. A patient's health plan is referred to as the "payer of Medicaid
last resort." The patient is covered by which of the
following health plans?
26. Red
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