CPB Certified Professional Biller Certification Exam Study Guide
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Course
CPB
Institution
CPB
CPB Certified Professional Biller
Certification Exam Study Guide
Abuse - ANSWER-Actions inconsistent with accepted, sound medical business or fiscal practice
Accept Assignment - ANSWER-Provider accepts as payment in full whatever is paid on the cliam by
the payer (except for any copayment and o...
inpatient hospital reimbursement rates for severity of illness (SOI) (extent of physiological
decompensation or organ system loss of function) and risk of mortality (ROM) (likelihood of dying); each
subclass, in turn, is subdivided into four areas: (1) minor, (2) moderate, (3) major, (4) extreme.
Ambulance Fee Schedule - ANSWER✔✔-Payment system for ambulance services provided to Medicare
Beneficiaries.
Ambulatory Payment Classification (APC) - ANSWER✔✔-Prospective payment system used to calculate
reimbursement for outpatient care according to similar clinical characteristics and in terms of resources
required.
Ambulatory Surgical Center (ASC) - ANSWER✔✔-State Licensed Medicare-certified supplier (not
provider) of surgical healthcare services that must accept assignment on Medicare Claims.
Ambulatory Surgical Center Payment Rate - ANSWER✔✔-Predetermined amount for which ASC services
are reimbursed, at 80 percent after adjument for regional wage variations.
Amendment to the HMO Act of 1973 - ANSWER✔✔-Legislation that allowed federally qualified HMOs to
permit members to occasionally use non HMO physicians and be partially reimbursed.
American Academy of Processional Coders (AAPC) - ANSWER✔✔-Professional association established to
provide a national certification and credentialing process, to support the national and local membership
by providing educational products and opportunities to network, and to increase and promote national
recognition and awareness of professional coding.
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