CPB

AAPC CPB - Chapter 11 Review Questions and Answers Medicare's payment amount for services are determined by which of the following formulas? a. Sustainable growth rate (SGR) X Geographic Practice Cost Index (GPCI) = Medicare payment b. Total RVU X Conversion factor = Medicare payment c. Total Practice Expense (PE) X Conversion factor = Medicare payment d. Total Malpractice insurance (MP) X Conversion factor (CF) = Medicare payment - Answer️️ -b. Total RVU X Conversion factor = Medi...

AAPC CPB - Chapter 9 Quiz with 100% Correct Answers When a claim has been paid, an EOB is sent to: a. the clearinghouse. b. the patient. c. the provider. d. the insurance company. - Answer️️ -b. the patient. Cost based fee schedules are developed using which of the following: a. RBRVS methodology b. total costs of every procedure or service listed in the CPT® c. total cost of all of the procedures the physician will perform d. malpractice insurance and office operating costs - Ans...

AAPC CPB - Chapter 2 Quiz with 100% Correct Answers 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 - Answer️️ -b. Cap...

CPB Practice Exam A Questions and Answers (100% Pass) The office policy for claims follow-up is to prioritize the insurance balance accounts past 90 days by highest outstanding balance. Based on the A/R report provided, which payer type and aging category would be one of the top priorities on which to focus collection efforts? - Answer️️ -workers' compensation, 121+ days Using the fee schedule and the payment policy provided, what is the expected reimbursement (including patient res...

AAPC CPB - Chapter 10 Review Questions and Answers Which statement is TRUE regarding the Prompt Payment Act? a. Patients are required to pay patient balances within 30 days. b. Patient balances are dismissed if a statement is not sent to the patient within 30 days. c. Federal agencies are not required to respond to all clean claims within 30 days of receipt. d. Federal agencies are required to pay clean claims within 30 days of receipt. - Answer️️ -d. Federal agencies are required t...

AAPC CPB - Chapter 12 Review Questions and Answers The term for the set payment that the member pays to the healthcare provider on the day of service is the: a. office visit fee. b. co-insurance. c. copay. d. co-signer. - Answer️️ -c. copay. Blue Cross/Blue Shield identifies the individual or employee who pays for healthcare insurance coverage as the: a. Member b. Group c. Subscriber d. Payer - Answer️️ -c. Subscriber ©SOPHIABENNET@ Thursday, August 22, 2024 10:21 AM Cert...

AAPC CPB Practice Exam Questions and Answers (100% Pass) Joe and Mary are a married couple and both carry insurance from their employers. Joe was born on February 23, 1977 and Mary was born on April 4, 1974. Using the birthday rule, who carries the primary insurance for their children for billing? A. Joe, because he is the male head of the household. B. Mary, because her date of birth is the 4th and Joe's date of birth is the 23rd. C. Mary, because her birth year is before Joe's birth...

AAPC CPB - Chapter 1 Review Questions and Answers What does the acronym PHI stand for? a. Patient Healthcare Information b. Patient History of Illness c. Protected Health Information d. Protected Healthcare Index - Answer️️ -c. Protected Health Information A new radiology company opens in town. The manager calls your practice and offers to pay $20 for every Medicare patient you send to them for radiology services. What does this offer violate? a. Stark Laws b. HIPAA c. Anti-Kickb...

AAPC CPB Final Exam Study Guide with Complete Solutions Health plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a: - Answer️️ -covered entity Which of the following is not a covered entity in the Privacy Rule - Answer️️ -healthcare consulting firm A request for medical records is received for a specific date of service from patient's insurance company with regards to a submitted claim. No authorization for release of i...