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CBCS PRACTISE TEST WITH QUESTIONS AND ANSWERS
- 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? Medicaid CHAMPA Medicare TRICARE ANS Medicaid
- A provider charged $500 to a claim that had an allowable amount of $400. In which of the following columns should the CBCS apply the non allowed charge? -Reference column (For notations) -Description column -Payment column -Adjustment column of the credits ANS Adjustment column of the credits
- Which of the following statements is correct regarding a deductible? -Coinsurance is a type of deductible -The physician should write off the deductible -The insurance company pays for the deductible -The deductible is the patient's responsibility ANS The deductible is the patient's responsibility
- Which of the following color formats allows optical scanning of the CMS-
1500 claim form?
- Red
- Blue
- Green -black ANS red
- Ambulatory surgery centers, home health and hospice organizations use the. -CMS-1500 claim form -UB-04 claim form -Advance Beneficiary notice -First report of injury form ANS UB- 04
- Claims that are submitted without an NPI number will delay payment to the provider because. -The number is the patient' id number -The number is needed to identify the provider -Is is used as a claim number -It is used as a pre authorization number ANS The number is needed to identify the provider
not been met. How much should the physician write off the patient's account?
- The unlisted codes can be found in which of the following locations in the CPT manual? -Appendix L -Guidelines prior to each section -End of each body system -Table of contents ANS Guidelines prior to each section
- Which of the following blocks should the billing and coding specialist complete the CMS 1500 claims form for procedure, services or supplies? -Block 12 -Block 2 -Block 24D
-Block 24J ANS Block 24D -Block 12 (patient's authorization block -Block 2 ( patient's name) -Block 24J ( for the rendering provider)
- Which of the following blocks requires the patient's authorization to re- lease medical information to process a claim? Block 12 Block 13 Block 27 Block 31 ANS Block 12
- Block 13 patient authorization for benefits required for third party payer
- Block 27 accepting assignment of benefits
- Block 31 (treating physician)
- Which of the following steps would be part of a physician's practice compliance program? -HIPAA compliance audit -Physician recruitment -Internal monitoring and auditing -Notice of privacy practice ANS Internal monitoring and auditing
-A CBCS queries the physician about a diagnosis in a patient's medical record -The physician uses his home phone to discuss patient care with the nursing staff -Patient information was disclosed to the patient's parents without consent ANS - Patient information was disclosed to the patient's parents without consent
- Which of the following is the purpose of running an aging report each month? -If indicates the balances the patients owe the provider -It indicates which patients have upcoming or missed appointment -It indicates which claims are outstanding -It indicates what the insurance company has paid for the provider's services to a patient. ANS It indicates which claims are outstanding
- Which of the following describes the status of a claim that does not include the required preauthorization for a service? -Delinquent (overdue)
- Denied
- Suspended -Adjudicated (claim still being processed) ANS Denied -Delinquent (overdue) -Adjudicated (claim still being processed)
- Which of the following actions should the CBCS take to prevent fraud and abuse in the medical office?
-Serviced procedure preauthorization -Internal monitoring and auditing -Utilization review -Correct coding initiative ANS Internal monitoring and auditing
- In an outpatient setting, which of the following forms is used as a financial report of all services provided to patients? -Encounter form -Patient account record -CMS-1500 claim form -Accounts receivable journal ANS Patient account record (patient ledger, all transac- tions between patient and the practice) -Accounts receivable journal (Day sheet = chronological summary of all transaction on a specific day)
- Patient charges that have not been paid will appear in which of the follow- ing? -Accounts receivable -Accounts payable
-A billing worksheet from the patient account -A superbill -A day sheet -Am accounts receivable report of the patient account ANS A billing worksheet from the patient account
- When a patient has a condition that is both acute and chronic, how should it be reported? -Code only the acute code -Code both acute and chronic, sequencing the acute first -Code only the chronic code -Code both acute and chronic, sequencing the chronic first ANS Code both acute and chronic, sequencing the acute first
- Which of the following types of health insurance plan best describes a government sponsored benefit program? -Unemployment compensation disability -TRICARE prime -Foundation for Medicare -Worker's compensation ANS TRICARE prime
-Unemployment compensation disability (state insurance covering non work related illness and injury)
- Accepting assignment on the CMS-1500 claim form indicates which of the following? -The patient agrees to accept payment and forward the payment to the physi- cian -The physician agrees to accept payment under the terms of the payer's program. -The physician agrees to bill according the third payer's fee schedule -The patient agrees to pay the difference between the billed amount and the allowed amount ANS The physician agrees to accept payment under the terms of the payer's program.
- Which of the following parts of the body system regulates immunity? -Endocrine system (regulates growth, metabolic) -Respiratory system (removes carbon dioxide) -Urinary system (filters blood to remove waste of cellular metabolism) -Lymphatic system ANS Lymphatic system -Endocrine system (regulates growth, metabolic) -Respiratory system (removes carbon dioxide) -Urinary system (filters blood to remove waste of cellular metabolism)
- Which of the following sections of the medical record is used to determine the correct evaluation and management code to use for billing and coding? -Codes used during prior patient visits -Patient's insurance plan
-Referring to the ICD book for the accurate description of the procedural code. ANS Billing using two digit CPT modifiers to indicate a procedure as performed differs from its usual five digit code
- Which of the following describes the content of a medical practice aging report? -An overview of the practice's net worth -An overview of the practice deposits. -An overview of the practice's debts -An overview of the practice's outstanding claims ANS An overview of the practice's outstanding claims
- Which of the following is the correct term for an amount that has been determined to be uncollectible? -Discounted fee -Bad debt -Financial hardship -Professional courtesy ANS bad debt
- Which of the following is the function of the respiratory system? -Deoxygenating blood cells -Oxygenating blood cells -Generating red blood cells -Generating white blood cells ANS Oxygenating blood cells
- A CBCS needs to know how much Medicare paid on a claim before billing the secondary insurance. To which of the following should the specialist refer? -Assignment of benefits -Medicare summary notice (how much the provider was billed and how much the patient has to pay) -Remittance advice -Coordination of benefits ANS remittance advice
- The standard medical abbreviation "ECG" refers to a test used to assess which of the following body systems? -Endocrine system -Cardiovascular system -Male reproductive system -Respiratory system ANS Cardiovascular system
- Which of the following blocks on the CMS-1500 claim form is used to bill ICD codes?
following? -Electronic remittance advice (response from insurance) -Direct data entry -Electronic fund transfer -Charge data entry ANS Direct data entry
- What is the maximum number of ICD codes that can be entered on a CMS- 1500 claim form as of February 2012? 4 6 10 12 ANS 12
- Medicare enforces mandatory submission of electronic claims for most providers. Which of the following providers' is allowed to submit paper claims to Medicare? -A provider's office with fewer than 10 full time employees -A provider's office with fewer than 25 full time employees -A Medicare advantage contractor (MAC)
-A provider who submits a secondary insurance claim ANS A provider's office with fewer than 10 full time employees
- Test results indicated that abnormalities were found in the brain's brain electrical activity patterns are normal. Which of the following tests was used to conduct the exam?
- EEG
- ECT
- EMG -EGD ANS EEG -ECT (electroconvulsive therapy - to treat major depression that does not respond to standard treatment) -EMG (electromyography = test and recording the electrical activity produced skele- tal muscles) -EGD (esophagogastroduodenoscopy = test that examines the lining of the esoph- agus, stomach and upper part of the small intestine)
- The destruction of lesions using cryosurgery would use which of the following treatments? -Laser treatment -Chemical peel treatment -Cold treatment -Electric current treatment ANS Cold treatment
-Ptosis (drooping) -Emesis (vomiting)
- Edema -Dilation (widening) ANS edema -Ptosis (drooping) -Emesis (vomiting) -Dilation (widening)
- Which of the following is an example of electronic claim submission? -Claim submitted via a secure network -Claims submitted via fax -Claims that are computer generated paper claims -Claims that are completed using the CMS-1500 claim form ANS claim submitted via a secure network
- Which of the following security features is required during transmission of protected health information and medical claims to third party payers? -Unique used IDs and passwords -Role based access controls -Electronic data interchange -Encryption ANS encryption
- Which of the following actions should the CBCS take to effectively manage accounts receivable?
-Collect payment from the patient at the time of service -Have the patient pat the balance up front and wait for reimbursement -Delay submission until the patient pays the deductible -Ask the patient to pay half now and bill the insurance for the balance ANS Collect payment from the patient at the time of service
- Which of the following insurance carriers is considered the payer of last resort?
- Medicaid
- Medicare
- TRICARE -Blue cross/shield ANS Medicaid
- Which of the following blocks on the CMS-1500 claim form is required to indicate a worker's compensation claim? 11a 21 10a 22 ANS 10a -11a primary injured date of birth and gender
