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...
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
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?
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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