Medical Billing and Coding Practice Test: Insurance, Compliance, and Regulations, Exams of Medicine

A practice test focused on medical billing and coding, covering topics such as insurance policies, claim submissions, and regulatory compliance. It includes multiple-choice questions addressing various aspects of healthcare administration, including understanding insurance benefits, identifying fraudulent activities, and adhering to hipaa regulations. The test is designed to assess knowledge and comprehension of key concepts in medical billing and coding, providing a valuable resource for students and professionals in the field. It covers scenarios related to medicare, tricare, and other insurance plans, testing the ability to apply coding guidelines and legal requirements in practical situations. The questions also explore ethical considerations and the importance of accurate documentation in healthcare billing practices. This practice test is a useful tool for preparing for certification exams and enhancing proficiency in medical billing and coding.

Typology: Exams

2024/2025

Available from 08/08/2025

kevo-tanker
kevo-tanker 🇺🇸

4

(4)

2.6K documents

1 / 8

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
1 / 13
AAPC CPB - Practice Test B
1. What is the term for the total amount of hidden healing expenses a policyholder must pay each year
out-of-pocket before the medical insurance guest starts to pay some benefits?
A. Copayment
B. Inferable
C. Subordinate Payment
D. Coinsurance >>> B. Inferable
2. That type of security covers physicians and different healthcare profes- sionals for burden concerning
claims emergent from patient treatment?
A. Trade responsibility
B. Sticking
C. Healing abuse
D. Workers' insurance system >>> C. Medical misconduct
3. That of the following does NOT fall under group tactics protection?
I. The premium is finance for one representative.
II. The premium is paid for (or incompletely finance) by an entrepreneur.
III. The manager selects the plan(s) to offer to attendants.
IV. Tangible exams and medical history questionnaires are a necessary constituent the request process.
V. Operator can create changes to the tactics.
VI. The representative's spouse and juveniles are not worthy for inclusion.
A. III, IV, and V
B. II, III, and VI
C. II, IV, and V
D. I, IV, V, and VI >>> D. I, IV, V, and VI
4. Dr. Wallace is in a charge levied by government on property contract accompanying Belleview Medical
insurance Health Plan. He taken $25,000 from the medical insurance to supply duties for the 175
enrollees on the medical insurance. The duties supported by Dr. Wallace to the enrollees cost $23,000.
Based on the facts, what must be finished?
pf3
pf4
pf5
pf8

Partial preview of the text

Download Medical Billing and Coding Practice Test: Insurance, Compliance, and Regulations and more Exams Medicine in PDF only on Docsity!

AAPC CPB - Practice Test B

  1. What is the term for the total amount of hidden healing expenses a policyholder must pay each year out-of-pocket before the medical insurance guest starts to pay some benefits? A. Copayment B. Inferable C. Subordinate Payment D. Coinsurance >>> B. Inferable
  2. That type of security covers physicians and different healthcare profes- sionals for burden concerning claims emergent from patient treatment? A. Trade responsibility B. Sticking C. Healing abuse D. Workers' insurance system >>> C. Medical misconduct
  3. That of the following does NOT fall under group tactics protection? I. The premium is finance for one representative. II. The premium is paid for (or incompletely finance) by an entrepreneur. III. The manager selects the plan(s) to offer to attendants. IV. Tangible exams and medical history questionnaires are a necessary constituent the request process. V. Operator can create changes to the tactics. VI. The representative's spouse and juveniles are not worthy for inclusion. A. III, IV, and V B. II, III, and VI C. II, IV, and V D. I, IV, V, and VI >>> D. I, IV, V, and VI
  4. Dr. Wallace is in a charge levied by government on property contract accompanying Belleview Medical insurance Health Plan. He taken $25,000 from the medical insurance to supply duties for the 175 enrollees on the medical insurance. The duties supported by Dr. Wallace to the enrollees cost $23,000. Based on the facts, what must be finished?

A. Dr. Wallace can maintain the $2,000 profit under the conditions of the capitated plan. B. Dr. Wallace knowledgeable a deficit under the capitated plan and will need to pay $2,000 to the health plan. C. Dr. Wallace will need to payout the $2,000 to the 175 enrollees. D. Dr. Wallace is necessary to set the $2,000 in a closed-end fund. >>> A. Dr. Wallace can hold the $2,000 profit under the agreements of the capitated plan.

  1. What is the time limit for ordering a Medicare claim? A. Individual period from the date assisting B. 30 days from the date beneficial C. 90 days from the date assisting D. Two age from the date of service >>> A. Individual old age from the date influential
  2. A householder sees a patient the one has TRICARE Select. The wage earner is not weakened with TRICARE but is verified apiece provincial TRICARE Medical insurance Support Builder (MCSC). The householder charges $200 for the office visit. TRICARE admits $160 and pays $140. By virtue of what much can the householder bill the patient for? A. $0. B. $20. C. $60. D. $160.00 >>> C. $60.
  3. What institution is trustworthy in judging the healing necessity, suitability, and adeptness of the use of healthcare aids and supporting- cedures? A. Exercise Review Arranging B. External Status Review Arranging C. Control of product quality Arranging D. Medical insurance Arrangement >>> A. Exercise Review Organization
  4. Medical insurance providers are prohibited in accordance with the law to

(PA)?

A. Doctor helpers cannot report E/M duties B. Only the 1995 CMS proof directions C. Only the 1997 CMS documentation directions D. Either 1995 or 1997 CMS proof directions >>> D. Either 1995 or 1997 CMS proof directions

  1. Select the synopsis that meets the incident-to necessities. A. The surgeon is in the commission series energetically discussing a patient and the surgeon assistant in the next range is discussing a new patient illness. B. Care is brought to an settled patient apiece physician helper as one the doctor's situation plan while the doctor is observing another patient in the alike office series in a various range. C. The doctor helper well-traveled for the physician to support the aid in the patient's New York City home and the specialist is free by telephone. D. The doctor helper provided a unavoidable some the patient's healing situation and the doctor marked the chart when he returned to the commission.-

B. Care is brought to an settled patient for one surgeon helper as few the physician's situation plan while the doctor is observing another patient in the alike commission series in a different range.

  1. Government-provided health care heir is bearing a hide colonoscopy acted. By means of what is the service stated to Government-provided health care? A. G B. 45378 C. 45378, G D. G0121, 45378 >>> A. G
  2. That providers endure the CMS-1500 claim form? I. Liberated demonstrative testing abilities (IDTFs) II. Crisis area physicians III. Emergency room arrangings IV. Transport associations submitting under their own Medical insurance number V. Physicians as one practice

VI. Peripatetic resection centers A. III-VI B. IV and VI C. I, III, IV, and VI D. I, II, IV, V and VI >>> D. I, II, IV, V and VI

  1. In accordance with CPT® Radiology Directions, if a patient is given spoken con- trast for a Computerized axial tomography of the midriff that law is stated? A. 74150 Computerized axial tomography scanner, abdomen; outside contrast material B. 74160 Computerized axial tomography scanner, tummy; accompanying contrast material(s) C. 74170 Computerized axial tomography scanner, tummy; without contrast material, fol- holler by contrast material(s) and further divisions D. 74176 Computerized axial tomography scanner, tummy and stomach; accompanying contrast materi- al(s) >>> A. 74150 Computerized axial tomography scanner, abdomen; outside contrast material
  2. That of the following is NOT in the HIPAA Solitude Rule? A. Specialist must acquire a patient's inscribed consent and authorization before utilizing or revealing PHI to complete activity situation. B. Executing fittings, program, and/or procedural mechanisms to record and test approach and additional action in facts schemes that contains or use photoelectric PHI (e-PHI). C. Doctor's commission leaving a idea on the patient's telephone message system to prove an job occasion. D. Patient is given better approach to welcome own record of what happened(s) and control over by virtue of what welcome PHI is used. >>> B. Executing fittings, program, and/or proce- dural means to record and analyze approach and added activity in news arrangements that holds or use photoelectric PHI (e-PHI).
  3. When a surgeon purposely bills procedures to Medical insurance that he acted not act he is in defilement of that Act? A. Authenticity in Loaning Act B. Federal Claims Accumulation Act C. Wrong Claims Act D. Medical insurance Ability to move and Responsibility Act >>> C. Fake Claims Act
  4. Cardiologist Dr. W has been usually newsgathering a taller E/M level than what is recorded to cover

Contractor (Desktop computer). B. Refund $450 back to the patient. C. Contact the Desktop computer of the overpayment and determine a refund. D. Use the $450 toward future co-security for the patient. >>> C. Contact the Desktop computer of the overpayment and supply a refund.

  1. Which individual is NOT a Nonphysician Expert (false name intervening-level wage earner)? A. Confirmed nurse obstetrician B. Resident C. Surgeon Helper D. Dispassionate public employees >>> B. Local
  2. Which General Standard demands inscribed acknowledgement of services advertising disputes and review of billing mistakes by creditors? A. Fair Credit Advertising Act B. Fair Credit and Credit card Announcement Act C. Equal Credit Moment Act D. Fair Credit Newsgathering Act >>> A. Fair Credit Billing Act
  3. Man Doyle had visualized a non-cooperating wage earner for a break repair in person being treated for medical problem abscission. His protection association Telehealth supported a refund- ment check of $400 for the sleep aids provided to him for the abscission. Man Doyle cashed the check and observed person engaged in private ownership of business. Man Doyle sustains the bill from the anesthesiologist, but he not any more has the money to pay it. The report enhances delinquent and is outsourced to a one who collects accounts. The one who collects accounts is sidelined to get any services from Man Doyle. What is this is thought-out? A. Past-due report B. Open claim C. Impending report D. Uncollectable debt >>> D. Bad debt
  4. Man A habit of activity is 67, retiring, and has security inclusion through Government-provided health care and TRICARE. Mrs. A habit of activity is 62 and still occupied for an corporation that has 10 representatives. Husband and wife Often injurious have fitness coverage through Adult Reliance' organization's group medical insurance, Combined Plan. Man Jones is visualized in a non-field hospital in

the ED for a fracture wrist. The one gets announced first? A. Medical insurance B. Group medical insurance, United Plan C. TRICARE D. Government-provided health care, the group medical insurance, and TRICARE will be announced though. >>> A. Medical insurance

  1. Relative Profit Units (RVUs) are fee elements comprising >>> A. Actual time for action or event of the doctor work; Place beneficial; Terrestrial adjust- ment B. Practice Payment; Demonstrative aids; Fee Rate C. Surgeon work; Practice Cost; Professional liability/abuse in- surance D. Patient categorization method; Terrestrial adaptation; Practice Payment-

C. Doctor work; Practice Expense; Professional responsibility/abuse security