NHA CBCS Final Exam and Certified Billing and Coding Specialist (CBCS) Exam Questions And Answers With Solutions Package Deal 2024/2025
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What describes the reason for a claim rejection because of Medicare NCCI edits - Improper code combinations A claim is submitted with a transposed insurance member ID number and returned to the provider. - Invalid Medigap coverage is offered to Medicare beneficiaries by whom - Private third- party p...
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Add to cartWhat describes the reason for a claim rejection because of Medicare NCCI edits - Improper code combinations A claim is submitted with a transposed insurance member ID number and returned to the provider. - Invalid Medigap coverage is offered to Medicare beneficiaries by whom - Private third- party p...
When is the principle diagnosis applicable? - Inpatient Hospital coding The term "encounter records" means: - claim What is the name of the act designed to address the collection practices of third- party debt collectors and attorneys who regularly collect debts for others? - Fair debt colle...
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Add to cartWhen is the principle diagnosis applicable? - Inpatient Hospital coding The term "encounter records" means: - claim What is the name of the act designed to address the collection practices of third- party debt collectors and attorneys who regularly collect debts for others? - Fair debt colle...
The symbol "O" in the Current Procedural Terminology reference is used to indicate what? - Reinstated or recycled code In the anesthesia section of the CPT manual, what are considered qualifying circumstances? - Add-on codes As of April 1, 2014 what is the maximum number of diagnoses that ca...
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Add to cartThe symbol "O" in the Current Procedural Terminology reference is used to indicate what? - Reinstated or recycled code In the anesthesia section of the CPT manual, what are considered qualifying circumstances? - Add-on codes As of April 1, 2014 what is the maximum number of diagnoses that ca...
A nurse is reviewing a patients lab results prior to discharge and discovers an elevated glucose level. Which of the following health care providers should be altered before the nurse can proceed with discharge planning? - The attending physician On the CMS-1500 Claims for, blocks 14 through 33 con...
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Add to cartA nurse is reviewing a patients lab results prior to discharge and discovers an elevated glucose level. Which of the following health care providers should be altered before the nurse can proceed with discharge planning? - The attending physician On the CMS-1500 Claims for, blocks 14 through 33 con...
A copay is the patient's share of the insurance premium. - False The term reconciliation means? - Determining how much the provider has been reimbursed and how much patient owes EOB (explanation of benefits) - Sent to policyholder RA (remittance advice) - Report from 3rd party payer to provide...
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Add to cartA copay is the patient's share of the insurance premium. - False The term reconciliation means? - Determining how much the provider has been reimbursed and how much patient owes EOB (explanation of benefits) - Sent to policyholder RA (remittance advice) - Report from 3rd party payer to provide...
What describes the reason for a claim rejection because of Medicare NCCI edits - Improper code combinations A claim is submitted with a transposed insurance member ID number and returned to the provider. - Invalid Medigap coverage is offered to Medicare beneficiaries by whom - Private third- party p...
Preview 3 out of 16 pages
Add to cartWhat describes the reason for a claim rejection because of Medicare NCCI edits - Improper code combinations A claim is submitted with a transposed insurance member ID number and returned to the provider. - Invalid Medigap coverage is offered to Medicare beneficiaries by whom - Private third- party p...
When a billing and coding specialist is completing the CMS-1500 claim form, which of the following information is required to process a medical claim? - CPT, ICD The allowed amount for a patient's office visit is $175. The copayment is $15 and the amount the insurance paid is $85. Which of the f...
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Add to cartWhen a billing and coding specialist is completing the CMS-1500 claim form, which of the following information is required to process a medical claim? - CPT, ICD The allowed amount for a patient's office visit is $175. The copayment is $15 and the amount the insurance paid is $85. Which of the f...
A patient presents to the provider with chest pain and shortness of breath. After an unexpected ECG result, the provider calls a cardiologist and summarizes the patient's symptoms. What portion of HIPAA allows the provider to speak to the cardiologist prior to obtaining the patient's consent? ...
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Add to cartA patient presents to the provider with chest pain and shortness of breath. After an unexpected ECG result, the provider calls a cardiologist and summarizes the patient's symptoms. What portion of HIPAA allows the provider to speak to the cardiologist prior to obtaining the patient's consent? ...
Medical Billing & Coding as a Career - *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Bill...
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Add to cartMedical Billing & Coding as a Career - *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Bill...
Medical Billing & Coding as a Career - *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Bill...
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Add to cartMedical Billing & Coding as a Career - *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Bill...
Missing #1 - blank A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - Invalid. Medigap coverage is offered to Medicare beneficiaries by? - Private Third-party payers This pr...
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Add to cartMissing #1 - blank A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - Invalid. Medigap coverage is offered to Medicare beneficiaries by? - Private Third-party payers This pr...
what do physicians use to electronically submit claims? - clearinghouse what is one purpose of an internal auditing program in a physician's office? - verifying that the medical records and the billing records match in which department should a patient be seen for psoriasis - dermatology * on a...
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Add to cartwhat do physicians use to electronically submit claims? - clearinghouse what is one purpose of an internal auditing program in a physician's office? - verifying that the medical records and the billing records match in which department should a patient be seen for psoriasis - dermatology * on a...
1. Missing #1 - BLANK 2. A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - INVALID 3. Medigap coverage is offered to Medicare beneficiaries by? - PRIVATE THIRD- PARTY PAYER ...
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Add to cart1. Missing #1 - BLANK 2. A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - INVALID 3. Medigap coverage is offered to Medicare beneficiaries by? - PRIVATE THIRD- PARTY PAYER ...
Medical Billing and Coding Certification Blocks 14 through 33 - The patient's condition and the provider's information are shown in what blocks in CMS 1500 form? Coding Compliance Plan - Which of the following includes procedures and best practices for correct coding? Use Arial size 10 font -...
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Add to cartMedical Billing and Coding Certification Blocks 14 through 33 - The patient's condition and the provider's information are shown in what blocks in CMS 1500 form? Coding Compliance Plan - Which of the following includes procedures and best practices for correct coding? Use Arial size 10 font -...
Which of the following is considered the final determination of the issues involving settlement of an insurance claim? - Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information is called which of the following? - Encounter form A patient comes to the hosp...
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Add to cartWhich of the following is considered the final determination of the issues involving settlement of an insurance claim? - Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information is called which of the following? - Encounter form A patient comes to the hosp...
Which of the following electronic forms is used to post payments? - Electronic remittance advice (ERA) If a clean claim is received March 1 of this year, which of the following is the allowable last day of payment in order to meet Medicare compliance requirements? - March 30 Threading a cathete...
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Add to cartWhich of the following electronic forms is used to post payments? - Electronic remittance advice (ERA) If a clean claim is received March 1 of this year, which of the following is the allowable last day of payment in order to meet Medicare compliance requirements? - March 30 Threading a cathete...
Requires documentation of the patient's informed consent. - urine pregnancy The patient should for a 24-hour urine specimen. - discard the first urine sample prior to collection 20/50 with no errors on the Snellen test means: - The patient can see at 20 feet what the normal eye sees at 50 feet....
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Add to cartRequires documentation of the patient's informed consent. - urine pregnancy The patient should for a 24-hour urine specimen. - discard the first urine sample prior to collection 20/50 with no errors on the Snellen test means: - The patient can see at 20 feet what the normal eye sees at 50 feet....
A would be the provider who would perform means the amount of reimbursement an insurance payer and patient agrees to pay a provider. - ALLOWED AMOUNT The appendix is located in the of the The investigates cases of fraud and prepares a referral for prosecution. - OFFICE OF THE INSPECTOR GENERAL A...
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Add to cartA would be the provider who would perform means the amount of reimbursement an insurance payer and patient agrees to pay a provider. - ALLOWED AMOUNT The appendix is located in the of the The investigates cases of fraud and prepares a referral for prosecution. - OFFICE OF THE INSPECTOR GENERAL A...
Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - Yes According to The Joint Commission, who may amend medical staff bylaws? - Medical Staff Failure to meet the established qualifications and criteria for appointment should be reported to ...
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Add to cartAre limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - Yes According to The Joint Commission, who may amend medical staff bylaws? - Medical Staff Failure to meet the established qualifications and criteria for appointment should be reported to ...
What two accreditors state: a hospital may not rely solely on board certification when considering practitioner for medical staff membership? - HFAP, CMS According to JC & HFAP name four approved sources PSV for Medical Education - Medical School, AMA, ECFMG, AOA According to NCQA practitioners mus...
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Add to cartWhat two accreditors state: a hospital may not rely solely on board certification when considering practitioner for medical staff membership? - HFAP, CMS According to JC & HFAP name four approved sources PSV for Medical Education - Medical School, AMA, ECFMG, AOA According to NCQA practitioners mus...
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