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CPB PRACTICE EXAM QUESTIONS AND ANSWERS 100% PASS

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CPB PRACTICE EXAM QUESTIONS AND ANSWERS 100% PASS WHO IS COVERED BY CHAMPVA? A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES B) ACTIVE DUTY MILITARY AND THEIR FAMILIES C) RETIRED MILITARY AND THEIR FAMILIES D) ACTIVE DUTY MILITARY OVER THE AGE OF 65 - answerA) VETERANS WI...

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  • October 28, 2024
  • 22
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • CPB
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Brightstars
©BRIGHTSTARS EXAM SOLUTIONS
10/21/2024 9:24 PM


CPB PRACTICE EXAM QUESTIONS AND
ANSWERS 100% PASS


WHO IS COVERED BY CHAMPVA?


A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES
B) ACTIVE DUTY MILITARY AND THEIR FAMILIES
C) RETIRED MILITARY AND THEIR FAMILIES

D) ACTIVE DUTY MILITARY OVER THE AGE OF 65 - answer✔A) VETERANS WITH
SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES


RATIONALE: THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE
DEPARTMENT OF VETERANS AFFAIRS (CHAMPVA) COVERS VETERANS WHO ARE
PERMANENTLY AND TOTALLY DISABLED DUE TO A SERVICE-RELATED
DISABILITY AND THEIR SPOUSE AND CHILDREN.
PATIENT IS BROUGHT TO THE LOCAL URGENT CARE AFTER FALLING FROM A
LADDER WHILE HANGING EXTERIOR LIGHTS ON HIS HOUSE. X-RAYS REVEALED
A CLOSED FRACTURE OF HIS LEFT FEMUR. THE PATIENT IS COVERED BY HIS
EMPLOYER'S GROUP HEALTH PLAN AND HE ALSO HAS A HOMEOWNER'S
LIABILITY INSURANCE POLICY. WHICH INSURANCE SHOULD BE BILLED?


A) THE HOMEOWNER'S INSURANCE FIRST, FOLLOWED BY THE GROUP HEALTH
PLAN
B) THE EMPLOYER'S GROUP HEALTH PLAN
C) THE HOMEOWNER'S INSURANCE ONLY

, ©BRIGHTSTARS EXAM SOLUTIONS
10/21/2024 9:24 PM

D) FILE THE EMPLOYER'S GROUP HEALTH PLAN AS PRIMARY AND LIST THE
HOMEOWNER'S INSURANCE AS SECONDARY. - answer✔B) THE EMPLOYER'S
GROUP HEALTH PLAN


RATIONALE: THE HEALTH INSURANCE PLAN IS BILLED FIRST AND THEN
THROUGH THE PROCESS OF SUBROGATION IT WILL BE DETERMINED IF A
LIABILITY PAYER SHOULD BE CONSIDERED PRIMARY.
3. PRIVATE COMPANIES CONTRACT WITH CMS TO ADMINISTER:


A) MEDICARE PART A & B
B) MEDICARE PART B
C) MEDICARE PART C

D) MEDICARE PART A, B, & C - answer✔D) MEDICARE PART A, B, AND C


RATIONALE: MEDICARE PART A, B, AND C ARE ALL ADMINISTERED BY PRIVATE
COMPANIES THAT CONTRACT WITH CMS AS MEDICARE ADMINISTRATIVE
CONTRACTORS OR MACs.
WHAT IS A CO-PAYMENT?


A) AN AMOUNT PAID EVERY MONTH BY THE POLICYHOLDER TO MAINTAIN
HEALTH INSURANCE COVERAGE
B) A PERCENTAGE OF THE ALLOWED AMOUNT THAT THE PATIENT IS
RESPONSIBLE FOR.
C) A FLAT AMOUNT PAID TO THE HEALTHCARE PROVIDER WHEN THE
POLICYHOLDER IS SEEN FOR AN OFFICE VISIT.
D) THE ADJUSTED AMOUNT BASED ON THE INSURANCE POLICY REQUIREMENT. -
answer✔C) A FLAT AMOUNT PAID TO THE HEALTHCARE PROVIDER WHEN THE
POLICY HOLDER IS SEEN FOR AN OFFICE VISIT.
WHICH OF THE FOLLOWING STATEMENTS IS TRUE REGARDING THE NON-PAR
MEDICARE ALLOWED FEE SCHEDULE?

, ©BRIGHTSTARS EXAM SOLUTIONS
10/21/2024 9:24 PM


A) THE NON-PAR PROVIDER CAN BILL THE PATIENT THE DIFFERENCE BETWEEN
THE CHARGE AND THE MEDICARE ALLOWABLE.
B) THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-PAR MEDICARE
PHYSICIAN FEE SCHEDULE
C) THE NON-PAR PHYSICIAN FEE SCHEDULE IS 115% OF THE PAR MEDICARE
PHYSICIAN FEE SCHEDULE
D) THE NON-PAR LIMITING CHARGE IS 95% OF THE PAR MEDICARE PHYSICIAN
FEE SCHEDULE. - answer✔B) THE NON-PAR LIMITING CHARGE IS 115% OF THE
NON-PAR MEDICARE PHYSICIAN FEE SCHEDULE.


RATIONALE: PER CMS, THE NON-PAR LIMITING CHARGE IS 115% OF THE NON-PAR
MEDICARE PHYSICIAN FEE SCHEDULE.
WHAT IS A MEDIGAP POLICY?


A) A POLICY THAT COVERS HEALTHCARE SERVICES THAT MEDICARE DOES NOT
COVER.
B) A POLICY THAT WILL NOT REIMBURSE FOR OUT-OF-POCKET COSTS NOT
COVERED BY MEDICARE
C) A SUPPLEMENTAL INSURANCE OFFERED BY CMS.

D) A POLICY REQUIRED BY MEDICARE. - answer✔A) A POLICY THAT COVERS
HEALTHCARE SERVICES THAT MEDICARE DOES NOT COVER.
MEDICARE PART A IS AVAILABLE TO INDIVIDUALS UNDER THE AGE OF 65 WHO
HAVE:


A) DIABETES MELLITUS TYPE I OR II
B) CKD (CHRONIC KIDNEY DISEASE)
C) ESRD AND MEET CERTAIN REQUIREMENTS

D) ANY CHRONIC HEALTH CONDITION - answer✔C) ESRD AND MEET CERTAIN
REQUIREMENTS.

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