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CBCS PRACTICE TEST| 187 questions| WITH COMPLETE SOLUTIONS $12.49   Add to cart

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CBCS PRACTICE TEST| 187 questions| WITH COMPLETE SOLUTIONS

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2. A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? Correct Answer: INVALID 3. Medigap coverage is offered to Medicare beneficiaries by? Correct Answer: PRIVATE THIRD-PAR...

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  • October 30, 2022
  • 11
  • 2022/2023
  • Exam (elaborations)
  • Questions & answers
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CBCS PRACTICE TEST| 187 questions| WITH
COMPLETE SOLUTIONS
2. A claim is submitted with a transposed insurance member ID number & returned to the
provider. This describes the status that should be assigned to the claim by the carrier? Correct
Answer: INVALID

3. Medigap coverage is offered to Medicare beneficiaries by? Correct Answer: PRIVATE
THIRD-PARTY PAYER

4. This provision ensures that an insured's benefits from all insurance companies does not exceed
100% of allowable medical Correct Answer: Coordination of benefits

5. A coroner's autopsy is comprised of which examination? Correct Answer: Gross examination.

6. This statement is true regarding the release of patient records? Correct Answer: Patient access
to psychotherapy notes may be restricted.

7. Actions by a billing & coding specialist would be considered fraud? Correct Answer: Billing
for services not provided.

8. The components of an explanation of benefits expedites the process of a phone appeal?
Correct Answer: Claim control number.

9. On the CMS-1500 claim form, blocks 14 through 33 contain information of?. Correct Answer:
The patient's condition & the provider's information

10. A billing & coding specialist should understand that the financial record source that is
generated by a provider's office is called a? Correct Answer: Patient Ledger Account.

11. The medical terms refer to the sac that endoses the heart? Correct Answer: Pericardium.

12. HIPAA transaction standards apply to? Correct Answer: Health care clearinghouse.

13. All dependents 10 years of age or older are required to have which of the following for
TRICARE? Correct Answer: Military identification.

14. The standard medical abbreviation "ECG" refers to a test used to assess? Correct Answer:
Cardiovascular system.

15. An example of a violation of an adult patient's confidentiality? Correct Answer: Patient
information was disclosed to the patient's parent without consent.

16. Claims that are submitted without an NPI number will delay payment to the provider
because? Correct Answer: the number is needed to identify the provider

, 17. Sections of the medical record is used to determine the correct Evaluation & Management
code used for billing & coding? Correct Answer: History & physical

18. Actions should be taken if an insurance company denies a service as not medically
necessary? Correct Answer: Appeal the decision with a provider's report.

19. Missing #19 Correct Answer: misssing

20. The function of the respiratory system? Correct Answer: Oxygenating blood cells

21. This describes a delinquent claim? Correct Answer: The claim is overdue for payment.

22. What actions should the billing & coding specialist take if he observes a colleague in an
unethical situation? Correct Answer: Report the incident to a supervisor.

23. 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 & applied $40 to the
patient's annual deductible. BC/BS paid the balance at 80%. How much should the patient expect
to pay? Correct Answer: $48.

24. This statement is correct regarding a deductible? Correct Answer: The deductible is the
patient's responsibility.

25. A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has
Medicare as her primary insurance. This form is required so the patient knows she may be
responsible for payment? Correct Answer: Advance Beneficiary Notice.

26. What is the purpose of precertification? Correct Answer: Verification of coverage.

27. What claims is submitted & then optically scanned by the insurance carrier & converted to an
electronic form? Correct Answer: Paper claim

28. What information is required on a patient account record? Correct Answer: Name & address
of guarantor.

29. This includes procedures & best practices for correct coding? Correct Answer: Coding
Compliance Plan.

30. A patient who has a primary malignant neoplasm of the lung should be referred to ? Correct
Answer: Pulmonary oncologist

31. ICD-9-CM codes describes the circumstances of a patient who sustained an accidental
fracture of the proximal tibia? Correct Answer: E887 Fracture, cause unspecified.

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