NHA CBCS CERTIFICATION Exam
Questions With Correct Answers 100% Pass
Which of the following provisions ensures that an insured's benefits from all insurance
companies do not exceed 100% of allowable medical expenses?☑️Correct Ans-Coordination of
benefits
NHA CBCS CERTIFICATION Exam
Questions With Correct Answers 100% Pass
Which of the following provisions ensures that an insured's benefits from all insurance
companies do not exceed 100% of allowable medical expenses?☑️Correct Ans-Coordination of
benefits
Which of the following actions should be taken first when reviewing a delinquent
claim?☑️Correct Ans-Verify the age of the account
Which of the following is the advantage of electronic claim submission?☑️Correct Ans-Claims
are expedited
Which of the following components of an explanation of benefits expedites the process of a
phone appeal?☑️Correct Ans-Claim control number
The standard medical abbreviation ECG refers to a test used to assess which of the following
body systems?☑️Correct Ans-Cardiovascular system
Which of the following actions by a billing and coding specialist would be considered
fraud?☑️Correct Ans-Billing for services not provided
The >< symbol is used to indicate a new and revised test other than which of the
following?☑️Correct Ans-Procedure descriptors
On the CMS-1500 claim form, blocks 14 through 33 contain information about which of the
following?☑️Correct Ans-The patient's condition and the provider's information
Which of the following includes procedures and best practices for correct coding?☑️Correct
Ans-Coding Compliance Plan
,When completing a CMS-1500 paper claim form, which of the following is an acceptable action
for the billing and coding specialist to take?☑️Correct Ans-Use arial size 10 font
A participating blue cross/blue shield (BC/BS) provider receives an explanation of benefits for a
patient account. The charged amount was $100. BC/BS allowed $80 and applied $40 to the
patient's annual deductible. BC/BS paid the balance at 80%. How much should the patient expect
to pay?☑️Correct Ans-$48
Which of the following indicates a claim should be submitted on paper instead of
electronically?☑️Correct Ans-The claim requires an attachment
According to HIPAA standards, which of the following identifies the rendering provider on the
CMS-1500 claim form in block 24j?☑️Correct Ans-NPI
Which of the following blocks should the billing and coding specialist complete on the CMS-
1500 claim form form for procedures, services or supplies (CPT/HCPCS)?☑️Correct Ans-
Block 24D
Which of the following terms describes when a plan pays 70% of the allowed amount and the
patient pays 30%?☑️Correct Ans-Coinsurance
A provider charged $500 to claim that had an allowable amount of $400. In which of the
following columns should the billing and coding specialist apply the non-allowed
charge?☑️Correct Ans-Adjustment column of the credits
Which of the following is a HIPAA compliance guideline affecting electronic health
records?☑️Correct Ans-The electronic transmission and code set standards require every
provider to use the healthcare transactions ,code sets and identifiers
Patient: Jane Austin; Social Security # 555-22-1111; Medicare ID: 555-33-2222A; DOB:
05/22/1945. Claim 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?☑️Correct Ans-The DOB is entered incorrectly
, Which of the following is considered the final determination of the issues involving settlement of
an insurance claim?☑️Correct Ans-Adjudication
A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information is
called which of the following?☑️Correct Ans-Encounter form
A patient comes to the hospital for an inpatient procedure. Which of the following hospital staff
members is responsible for the initial patient interview, obtaining demographic and insurance
information, and documenting the chief complaint?☑️Correct Ans-Admitting clerk
Which of the following privacy measures ensures protected health information (phi)?☑️Correct
Ans-Using data encryption software on office workstations
Which of the following planes divides the body into left and right?☑️Correct Ans-Sagittal
Why does correct claim processing rely on accurately completed encounter forms?☑️Correct
Ans-They streamline patient billing by summarizing the services rendered for a given date of
service
A patient's health plan is referred to as the "payer of last resort." The patient is covered by which
of the following health plans?☑️Correct Ans-Medicaid
Which of the following color formats is acceptable on the CMS-1500 claim form?☑️Correct
Ans-Red
Which of the following is an example of a violation of an adult patient's
confidentiality?☑️Correct Ans-Patient information was disclosed to the patient's parents
without consent.
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