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CPB PRACTICE EXAM QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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CPB PRACTICE EXAM QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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CPB PRACTICE EXAM QUESTIONS ANDANSWERS WITH SOLUTIONS 2024
WHO IS COVERED BY CHAMPVA?
O O O O
A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES
O O O O O O O O O O
B) ACTIVE DUTY MILITARY AND THEIR FAMILIES
O O O O O O
C) RETIRED MILITARY AND THEIR FAMILIES
O O O O O
D) ACTIVE DUTY MILITARY OVER THE AGE OF 65 - ANSWER A) VETERANS WITH SERVICE -
O O O O O O O O O O O O O O O
CONNECTED DISABILITIES AND THEIR FAMILIES
O O O O O
RATIONALE: THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIR
O O O O O O O O O O O O
S (CHAMPVA) COVERS VETERANS WHO ARE PERMANENTLY AND TOTALLY DISABLED DUE TO A SERVICE-
O O O O O O O O O O O O O
RELATED DISABILITY AND THEIR SPOUSE AND CHILDREN.
O O O O O O
PATIENT IS BROUGHT TO THE LOCAL URGENT CARE AFTER FALLING FROM A LADDER WHILE HANGING E
O O O O O O O O O O O O O O O
XTERIOR LIGHTS ON HIS HOUSE. X- O O O O O
RAYS REVEALED A CLOSED FRACTURE OF HIS LEFT FEMUR. THE PATIENT IS COVERED BY HIS EMPLOYER'S
O O O O O O O O O O O O O O O O
GROUP HEALTH PLAN AND HE ALSO HAS A HOMEOWNER'S LIABILITY INSURANCE POLICY. WHICH INSUR
O O O O O O O O O O O O O
ANCE SHOULD BE BILLED?
O O O
A) THE HOMEOWNER'S INSURANCE FIRST, FOLLOWED BY THE GROUP HEALTH PLAN
O O O O O O O O O O
B) THE EMPLOYER'S GROUP HEALTH PLAN
O O O O O
C) THE HOMEOWNER'S INSURANCE ONLY
O O O O
D) FILE THE EMPLOYER'S GROUP HEALTH PLAN AS PRIMARY AND LIST THE HOMEOWNER'S INSURANCE
O O O O O O O O O O O O O O
AS SECONDARY. - ANSWER B) THE EMPLOYER'S GROUP HEALTH PLAN
O O O O O O O O O
RATIONALE: THE HEALTH INSURANCE PLAN IS BILLED FIRST AND THEN THROUGH THE PROCESS OF SUBR
O O O O O O O O O O O O O O
OGATION IT WILL BE DETERMINED IF A LIABILITY PAYER SHOULD BE CONSIDERED PRIMARY.
O O O O O O O O O O O O
3. PRIVATE COMPANIES CONTRACT WITH CMS TO ADMINISTER:
O O O O O O O
A) MEDICARE PART A & B
O O O O O
,B) MEDICARE PART B
O O O
C) MEDICARE PART C
O O O
D) MEDICARE PART A, B, & C - ANSWER D) MEDICARE PART A, B, AND C
O O O O O O O O O O O O O O O
RATIONALE: MEDICARE PART A, B, AND C ARE ALL ADMINISTERED BY PRIVATE COMPANIES THAT CONTR
O O O O O O O O O O O O O O
ACT WITH CMS AS MEDICARE ADMINISTRATIVE CONTRACTORS OR MACs.
O O O O O O O O
WHAT IS A CO-PAYMENT?
O O O O
A) AN AMOUNT PAID EVERY MONTH BY THE POLICYHOLDER TO MAINTAIN HEALTH INSURANCE COVERA
O O O O O O O O O O O O O
GE
B) A PERCENTAGE OF THE ALLOWED AMOUNT THAT THE PATIENT IS RESPONSIBLE FOR.
O O O O O O O O O O O O
C) A FLAT AMOUNT PAID TO THE HEALTHCARE PROVIDER WHEN THE POLICYHOLDER IS SEEN FOR AN OF
O O O O O O O O O O O O O O O O
FICE VISIT.
O
D) THE ADJUSTED AMOUNT BASED ON THE INSURANCE POLICY REQUIREMENT. -
O O O O O O O O O O
OANSWER C) A FLAT AMOUNT PAID TO THE HEALTHCARE PROVIDER WHEN THE POLICY HOLDER IS SEEN
O O O O O O O O O O O O O O O O
FOR AN OFFICE VISIT.
O O O
WHICH OF THE FOLLOWING STATEMENTS IS TRUE REGARDING THE NON-
O O O O O O O O O
PAR MEDICARE ALLOWED FEE SCHEDULE?
O O O O
A) THE NON-
O O
PAR PROVIDER CAN BILL THE PATIENT THE DIFFERENCE BETWEEN THE CHARGE AND THE MEDICARE ALL
O O O O O O O O O O O O O O
OWABLE.
B) THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-PAR MEDICARE PHYSICIAN FEE SCHEDULE
O O O O O O O O O O O O O
C) THE NON-PAR PHYSICIAN FEE SCHEDULE IS 115% OF THE PAR MEDICARE PHYSICIAN FEE SCHEDULE
O O O O O O O O O O O O O O
D) THE NON-PAR LIMITING CHARGE IS 95% OF THE PAR MEDICARE PHYSICIAN FEE SCHEDULE. -
O O O O O O O O O O O O O O
OANSWER B) THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-
O O O O O O O O O O
PAR MEDICARE PHYSICIAN FEE SCHEDULE.
O O O O O
RATIONALE: PER CMS, THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-
O O O O O O O O O O O
PAR MEDICARE PHYSICIAN FEE SCHEDULE.
O O O O
, WHAT IS A MEDIGAP POLICY?
O O O O
A) A POLICY THAT COVERS HEALTHCARE SERVICES THAT MEDICARE DOES NOT COVER.
O O O O O O O O O O O
B) A POLICY THAT WILL NOT REIMBURSE FOR OUT-OF-POCKET COSTS NOT COVERED BY MEDICARE
O O O O O O O O O O O O O
C) A SUPPLEMENTAL INSURANCE OFFERED BY CMS.
O O O O O O
D) A POLICY REQUIRED BY MEDICARE. -
O O O O O O
ANSWER A) A POLICY THAT COVERS HEALTHCARE SERVICES THAT MEDICARE DOES NOT COVER.
O O O O O O O O O O O O O
MEDICARE PART A IS AVAILABLE TO INDIVIDUALS UNDER THE AGE OF 65 WHO HAVE:
O O O O O O O O O O O O O
A) DIABETES MELLITUS TYPE I OR II
O O O O O O
B) CKD (CHRONIC KIDNEY DISEASE)
O O O O
C) ESRD AND MEET CERTAIN REQUIREMENTS
O O O O O
D) ANY CHRONIC HEALTH CONDITION - ANSWER C) ESRD AND MEET CERTAIN REQUIREMENTS.
O O O O O O O O O O O O
RATIONALE: MEDICARE PART A COVERAGE IS AVAILABLE TO INDIVIDUALS BELOW THE AGE OF 65 WHO H
O O O O O O O O O O O O O O O
AVE; 1) RECEIVED SOCIAL SECURITY OR RRB DISABILITY BENEFITS FOR 24 MONTHS, 2) END-
O O O O O O O O O O O O O
STAGE RENAL DISEASE AND MEET CERTAIN REQUIREMENTS
O O O O O O
WHICH OF THE FOLLOWING STATEMENTS IS TRUE REGARDING MEDICAID?
O O O O O O O O
A) MEDICAID ELIGIBILITY POLICIES ARE THE SAME FOR STATES OF SIMILAR SIZE AND GEOGRAPHIC REGIO
O O O O O O O O O O O O O O
N.
B) MEDICAID ELIGIBILITY IS CLEAR AND CONSISTENT FROM STATE TO STATE
O O O O O O O O O O
C) MEDICAID PROGRAMS RECEIVE MATCHING FFEDERAL FUNDING ONLY IF CERTAIN HEALTHCARE SERVI
O O O O O O O O O O O
CES ARE PROVIDED TO ELIGIBLE INDIVIDUALS.
O O O O O
D) MEDICAID PROGRAMS MUST PROVIDE MEDICAL ASSISTANCE FOR ALL POOR PERSONS. -
O O O O O O O O O O O
ANSWER C) MEDICAID PROGRAMS RECEIVE MATCHING FEDERAL FUNDING ONLY IF CERTAIN HEALTHCA
O O O O O O O O O O O O
RE SERVICES ARE PROVIDED TO ELIGBLE INDIVIDUALS.
O O O O O O
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