NHA CBCS CERTIFICATION EXAM COMPLETE EXAM QUESTIONS AND ANSWERS.
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NHA CBCS CERTIFICATION
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NHA CBCS CERTIFICATION
NHA CBCS CERTIFICATION EXAM COMPLETE EXAM QUESTIONS AND ANSWERS.
Which of the following is considered the final determination of the issues involving settlement of an insurance claim? - Correct Answer: - Adjudication
A form that contains charges, DOS, CPT codes, ICD codes, fees and copaym...
NHA CBCS CERTIFICATION EXAM 2025-2026
COMPLETE EXAM QUESTIONS AND ANSWERS.
Which of the following is considered the final determination of the issues involving settlement of
an insurance claim? - Correct Answer: - Adjudication
A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information is
called which of the following? - Correct Answer: - Encounter form
A patient comes to the hospital for an inpatient procedure. Which of the following hospital staff
members is responsible for the initial patient interview, obtaining demographic and insurance
information, and documenting the chief complaint? - Correct Answer: - Admitting clerk
Which of the following privacy measures ensures protected health information (phi)? - Correct
Answer: - Using data encryption software on office workstations
Which of the following planes divides the body into left and right? - Correct Answer: - Sagittal
Which of the following provisions ensures that an insured's benefits from all insurance companies
do not exceed 100% of allowable medical expenses? - Correct Answer: - Coordination of benefits
Which of the following actions should be taken first when reviewing a delinquent claim? - Correct
Answer: - Verify the age of the account
Which of the following is the advantage of electronic claim submission? - Correct Answer: -
Claims are expedited
Which of the following components of an explanation of benefits expedites the process of a
phone appeal? - Correct Answer: - Claim control number
The standard medical abbreviation ECG refers to a test used to assess which of the following body
systems?
- Correct Answer: - Cardiovascular system
Which of the following actions by a billing and coding specialist would be considered fraud? -
Correct Answer: - Billing for services not provided
The >< symbol is used to indicate a new and revised test other than which of the following? -
,Correct Answer: - Procedure descriptors
On the CMS-1500 claim form, blocks 14 through 33 contain information about which of the
following? - Correct Answer: - The patient's condition and the provider's information
Which of the following includes procedures and best practices for correct coding? - Correct
Answer: - Coding Compliance Plan
When completing a CMS-1500 paper claim form, which of the following is an acceptable action
for the billing and coding specialist to take? - Correct Answer: - Use arial size 10 font
A participating blue cross/blue shield (BC/BS) provider receives an explanation of benefits for a
patient account. The charged amount was $100. BC/BS allowed $80 and applied $40 to the
patient's annual deductible. BC/BS paid the balance at 80%. How much should the patient expect
to pay? - Correct Answer: - $48
Which of the following indicates a claim should be submitted on paper instead of electronically?
- Correct Answer: - The claim requires an attachment
According to HIPAA standards, which of the following identifies the rendering provider on the
CMS-1500 claim form in block 24j?
- Correct Answer: - NPI
Which of the following blocks should the billing and coding specialist complete on the CMS-1500
claim form for procedures, services or supplies (CPT/HCPCS)? - Correct Answer: - Block 24D
Which of the following terms describes when a plan pays 70% of the allowed amount and the
patient pays 30%? - Correct Answer: - Coinsurance
A provider charged $500 to claim that had an allowable amount of $400. In which of the following
columns should the billing and coding specialist apply the non- allowed charge? - Correct Answer:
- Adjustment column of the credits
Which of the following is a HIPAA compliance guideline affecting electronic health records?
- Correct Answer: - The electronic transmission and code set standards require every provider to
use the healthcare transactions, code sets and identifiers
Patient: Jane Austin; Social Security # 555-22-1111; Medicare ID: 555-33-2222A; DOB:
05/22/1945. Claim information entered: Austin, Jane; Social Security #.: 555-22-1111; Medicare
, ID No.: 555-33-2222A; DOB: 052245. Which of the
following is a reason this claim was rejected? - Correct Answer: - The DOB is entered incorrectly
Why does correct claim processing rely on accurately completed encounter forms? - Correct
Answer: - They streamline patient billing by summarizing the services rendered for a given date of
service
A patient's health plan is referred to as the "payer of last resort." The patient is covered by which
of the following health plans? - Correct Answer: - Medicaid
Which of the following color formats is acceptable on the CMS-1500 claim form? - Correct
Answer: - Red
Which of the following is an example of a violation of an adult patient's confidentiality? - Correct
Answer: - Patient information was disclosed to the patient's parents without consent.
In the anesthesia section of the CPT manual, which of the following are considered qualifying
circumstances? - Correct Answer: - Add-on codes
Ambulatory surgery centers, home health care, and hospice organizations use the - Correct
Answer: - UB-04 claim form
Which of the following is a private insurance carrier? - Correct Answer: - Blue Cross/ Blue Shield
Which of the following shows outstanding balances? - Correct Answer: - Aging report
Which of the following is one of the purposes of an internal auditing program in a physician's
office? - Correct Answer: - Verifying that the medical records and the billing record match
The star symbol in the CPT code book is used to indicate which of the following? - Correct
Answer: - Telemedicine
Medigap coverage is offered to Medicare beneficiaries by which of the following? - Correct
Answer: - Private third party payers
A patient's portion of the bill should be discussed with the patient before a procedure is
performed for which of the following reasons? - Correct Answer: - To ensure the patient
understands his portion of the bill
The physician bills $500 to a patient. After submitting the claim to the insurance company, the
claim is sent back with no payment. The patient still owes $500 for this year. This amount is
called- Correct Answer: - Deductible
A patient who is an active member of the military recently returned from overseas and is in need
of specialty care. The patient does not have anyone designated with power of attorney. Which of
the following is considered a HIPAA violation? - Correct Answer: - The billing and coding
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