Exam (elaborations)
CBCS practice test 2024/2025 graded A+
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CBCS practice test 2024/2025 graded A+
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CBCSpractice
test
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?
Medicaid
CHAMPA
Medicare
TRICARE
-
ANSMedicaid
A
provider
charged
$500
to
a
claim
that
had
an
allowable
amount
of
$400.
In
which
of
the
following
columns
should
the
CBCS
apply
the
non
allowed
charge?
-Reference
column
(For
notations)
-Description
column
-Payment
column
-Adjustment
column
of
the
credits
-
ANSAdjustment
column
of
the
credits
Which
of
the
following
statements
is
correct
regarding
a
deductible?
-Coinsurance
is
a
type
of
deductible
-The
physician
should
write
off
the
deductible
-The
insurance
company
pays
for
the
deductible
-The
deductible
is
the
patient's
responsibility
-
ANSThe
deductible
is
the
patient's
responsibility
Which
of
the
following
color
formats
allows
optical
scanning
of
the
CMS-1500
claim
form?
-Red
-Blue
-Green
-black
-
ANSred
Ambulatory
surgery
centers,
home
health
and
hospice
organizations
use
the
______.
-CMS-1500
claim
form
-UB-04
claim
form
-Advance
Beneficiary
notice
-First
report
of
injury
form
-
ANSUB-04
Claims
that
are
submitted
without
an
NPI
number
will
delay
payment
to
the
provider
because
______.
-The
number
is
the
patient'
id
number
-The
number
is
needed
to
identify
the
provider
-Is
is
used
as
a
claim
number
-It
is
used
as
a
pre
authorization
number
-
ANSThe
number
is
needed
to
identify
the
provider
Which
of
the
following
terms
describes
when
a
plan
pays
70%
of
the
allowed
amount
and
the
patient
pays
30%?
-Coinsurance -Deductible
-Premium
-copayment
-
ANScoinsurance
Which
of
the
following
indicates
a
claim
should
be
submitted
on
paper
instead
of
electronically?
-The
software
claims
review
process
indicates
the
claim
is
not
complete
-The
claim
needs
authorization
-The
claim
requires
an
attachment
-The
practice
management
software
is
non
functional.
-
ANSthe
claim
requires
an
attachment
On
a
remittance
advice
form,
which
of
the
following
is
responsible
for
writing
off
the
difference
between
the
amount
billed
and
the
amount
allowed
by
the
agreement?
-Provider
-Insurance
company
-Patient
-Third
party
payer
-
ANSprovider
A
physician
is
contracted
with
an
insurance
company
to
accept
the
amount.
The
insurance
company
allows
$80
of
a
$120
billed
amount,
and
$50
of
the
deductible
has
not
been
met.
How
much
should
the
physician
write
off
the
patient's
account?
-$40
-$15
-$0
-$50
-
ANS$40
The
unlisted
codes
can
be
found
in
which
of
the
following
locations
in
the
CPT
manual?
-Appendix
L
-Guidelines
prior
to
each
section
-End
of
each
body
system
-Table
of
contents
-
ANSGuidelines
prior
to
each
section
Which
of
the
following
blocks
should
the
billing
and
coding
specialist
complete
the
CMS
1500
claims
form
for
procedure,
services
or
supplies?
-Block
12
-Block
2
-Block
24D
-Block
24J
-
ANSBlock
24D
-Block
12
(patient's
authorization
block
-Block
2
(
patient's
name)
-Block
24J
(
for
the
rendering
provider)
Which
of
the
following
blocks
requires
the
patient's
authorization
to
release
medical
information
to
process
a
claim?
Block
12
Block
13
Block
27 Block
31
-
ANSBlock
12
-
Block
13
patient
authorization
for
benefits
required
for
third
party
payer
-
Block
27
accepting
assignment
of
benefits
-
Block
31
(treating
physician)
Which
of
the
following
steps
would
be
part
of
a
physician's
practice
compliance
program?
-HIPAA
compliance
audit
-Physician
recruitment
-Internal
monitoring
and
auditing
-Notice
of
privacy
practice
-
ANSInternal
monitoring
and
auditing
Behavior
plays
an
important
part
of
being
a
team
player
in
a
medical
practice.
Which
of
the
following
is
an
appropriate
action
for
the
CBCS
to
take?
-Reprimanding
another
staff
member
during
a
team
meeting
for
displaying
a
bad
attitude
toward
a
patient
-Looking
in
the
medical
record
of
a
friend
who
receives
services
at
the
office
-Communicating
with
the
front
desk
staff
during
a
team
meeting
about
missing
information
in
patient
files
-Questioning
the
nurse
about
the
provider
documentation
in
the
medical
record
-
ANSCommunicating
with
the
front
desk
staff
during
a
team
meeting
about
missing
information
in
patient
files
Which
of
the
following
acts
applies
to
the
administrative
simplification
guideline?
-HIPAA
-Deficit
reduction
act
of
2005
-The
patient
protection
and
affordable
care
act
2009
-National
correct
coding
initiative
of
1995
-
ANSHIPAA
Which
of
the
following
is
an
example
of
a
violation
of
an
adult
patient's
confidentiality?
-While
reviewing
a
claim,
the
CBCS
reads
the
diagnosis
before
realizing
that
the
patient
is
a
neighbor
-A
CBCS
queries
the
physician
about
a
diagnosis
in
a
patient's
medical
record
-The
physician
uses
his
home
phone
to
discuss
patient
care
with
the
nursing
staff
-Patient
information
was
disclosed
to
the
patient's
parents
without
consent
-
ANSPatient
information
was
disclosed
to
the
patient's
parents
without
consent
Which
of
the
following
is
the
purpose
of
running
an
aging
report
each
month?
-If
indicates
the
balances
the
patients
owe
the
provider
-It
indicates
which
patients
have
upcoming
or
missed
appointment
-It
indicates
which
claims
are
outstanding
-It
indicates
what
the
insurance
company
has
paid
for
the
provider's
services
to
a
patient.
-
ANSIt
indicates
which
claims
are
outstanding
Which
of
the
following
describes
the
status
of
a
claim
that
does
not
include
the
required
preauthorization
for
a
service?
-Delinquent
(overdue)
-Denied
-Suspended -Adjudicated
(claim
still
being
processed)
-
ANSDenied
-Delinquent
(overdue)
-Adjudicated
(claim
still
being
processed)
Which
of
the
following
actions
should
the
CBCS
take
to
prevent
fraud
and
abuse
in
the
medical
office?
-Serviced
procedure
preauthorization
-Internal
monitoring
and
auditing
-Utilization
review
-Correct
coding
initiative
-
ANSInternal
monitoring
and
auditing
In
an
outpatient
setting,
which
of
the
following
forms
is
used
as
a
financial
report
of
all
services
provided
to
patients?
-Encounter
form
-Patient
account
record
-CMS-1500
claim
form
-Accounts
receivable
journal
-
ANSPatient
account
record
(patient
ledger,
all
transactions
between
patient
and
the
practice)
-Accounts
receivable
journal
(Day
sheet
=
chronological
summary
of
all
transaction
on
a
specific
day)
Patient
charges
that
have
not
been
paid
will
appear
in
which
of
the
following?
-Accounts
receivable
-Accounts
payable
-Tracer
-Rejected
claim
-
ANSAccounts
receivable
Which
of
the
following
is
considered
the
final
determination
of
the
issues
involving
settlement
of
an
insurance
claim?
-Processing
-Translation
-Adjudication
-Transmission
-
ANSAdjudication
(process
of
putting
a
claim
through
a
series
of
edits
for
final
determination)
-Processing
(
handling
a
claim
from
the
first
encounter
to
claim
submission)
-Translation
(claim
is
send
from
the
host
system
to
the
clearing
house)
-Transmission
(how
the
claim
was
sent)
Which
of
the
following
information
should
the
CBCS
input
into
block
33a
on
the
CMS-1500
claim
form
-Provider
social
security
number
(no
Social
security
number
on
CMS1500)
-Federal
tax
id
number
(entered
in
block
25)
-Patient
id
number
(on
block
1a)
-National
provider
identification
number
-
ANSNational
provider
identification
number
A
prospective
billing
account
audit
prevents
fraud
by
reviewing
and
comparing
a
completed
claim
form
with
which
of
the
following
documents?
-A
billing
worksheet
from
the
patient
account
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