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A series of multiple-choice questions and answers related to healthcare billing and coding practices. It covers topics such as patient health plans, claim submission procedures, coding guidelines, and compliance regulations. The questions are designed to test knowledge of the cbcs (certified billing and coding specialist) exam curriculum.
Typology: Exams
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A Gpatient's Ghealth Gplan Gis Greferred Gto Gas Gthe Gpayer Gof Glast Gresort. GThe Gpatient Gis Gcovered Gby Gwhich Gof Gthe Gfollowing Ghealth Gplans? Medicaid CHAMPA Medicare TRICARE G- Gcorrect Ganswers G-Medicaid A Gprovider Gcharged G$500 Gto Ga Gclaim Gthat Ghad Gan Gallowable Gamount Gof G$400. GIn Gwhich Gof Gthe Gfollowing Gcolumns Gshould Gthe GCBCS Gapply Gthe Gnon Gallowed Gcharge? -Reference Gcolumn G(For Gnotations) -Description Gcolumn -Payment Gcolumn
-Adjustment Gcolumn Gof Gthe Gcredits G- Gcorrect Ganswers G-Adjustment Gcolumn Gof Gthe Gcredits Which Gof Gthe Gfollowing Gstatements Gis Gcorrect Gregarding Ga Gdeductible? -Coinsurance Gis Ga Gtype Gof Gdeductible -The Gphysician Gshould Gwrite Goff Gthe Gdeductible -The Ginsurance Gcompany Gpays Gfor Gthe Gdeductible -The Gdeductible Gis Gthe Gpatient's Gresponsibility G- Gcorrect Ganswers G-The Gdeductible Gis Gthe Gpatient's Gresponsibility Which Gof Gthe Gfollowing Gcolor Gformats Gallows Goptical Gscanning Gof Gthe GCMS-1500 Gclaim Gform? -Red -Blue -Green -black G- Gcorrect Ganswers G-red Ambulatory Gsurgery Gcenters, Ghome Ghealth Gand Ghospice Gorganizations Guse Gthe G______. -CMS-1500 Gclaim Gform -UB-04 Gclaim Gform -Advance GBeneficiary Gnotice -First Greport Gof Ginjury Gform G- Gcorrect Ganswers G-UB- Claims Gthat Gare Gsubmitted Gwithout Gan GNPI Gnumber Gwill Gdelay Gpayment Gto Gthe Gprovider Gbecause G______. -The Gnumber Gis Gthe Gpatient' Gid Gnumber -The Gnumber Gis Gneeded Gto Gidentify Gthe Gprovider -Is Gis Gused Gas Ga Gclaim Gnumber -It Gis Gused Gas Ga Gpre Gauthorization Gnumber G- Gcorrect Ganswers G-The Gnumber Gis Gneeded Gto Gidentify Gthe Gprovider Which Gof Gthe Gfollowing Gterms Gdescribes Gwhen Ga Gplan Gpays G70% Gof Gthe Gallowed Gamount Gand Gthe Gpatient Gpays G30%? -Coinsurance -Deductible -Premium -copayment G- Gcorrect Ganswers G-coinsurance Which Gof Gthe Gfollowing Gindicates Ga Gclaim Gshould Gbe Gsubmitted Gon Gpaper Ginstead Gof Gelectronically? -The Gsoftware Gclaims Greview Gprocess Gindicates Gthe Gclaim Gis Gnot Gcomplete -The Gclaim Gneeds Gauthorization -The Gclaim Grequires Gan Gattachment -The Gpractice Gmanagement Gsoftware Gis Gnon Gfunctional. G- Gcorrect Ganswers G-the Gclaim Grequires Gan Gattachment
Which Gof Gthe Gfollowing Gsteps Gwould Gbe Gpart Gof Ga Gphysician's Gpractice Gcompliance Gprogram? -HIPAA Gcompliance Gaudit -Physician Grecruitment -Internal Gmonitoring Gand Gauditing -Notice Gof Gprivacy Gpractice G- Gcorrect Ganswers G-Internal Gmonitoring Gand Gauditing Behavior Gplays Gan Gimportant Gpart Gof Gbeing Ga Gteam Gplayer Gin Ga Gmedical Gpractice. GWhich Gof Gthe Gfollowing Gis Gan Gappropriate Gaction Gfor Gthe GCBCS Gto Gtake? -Reprimanding Ganother Gstaff Gmember Gduring Ga Gteam Gmeeting Gfor Gdisplaying Ga Gbad Gattitude Gtoward Ga Gpatient -Looking Gin Gthe Gmedical Grecord Gof Ga Gfriend Gwho Greceives Gservices Gat Gthe Goffice -Communicating Gwith Gthe Gfront Gdesk Gstaff Gduring Ga Gteam Gmeeting Gabout Gmissing Ginformation Gin Gpatient Gfiles -Questioning Gthe Gnurse Gabout Gthe Gprovider Gdocumentation Gin Gthe Gmedical Grecord G- Gcorrect Ganswers G-Communicating Gwith Gthe Gfront Gdesk Gstaff Gduring Ga Gteam Gmeeting Gabout Gmissing Ginformation Gin Gpatient Gfiles Which Gof Gthe Gfollowing Gacts Gapplies Gto Gthe Gadministrative Gsimplification Gguideline? -HIPAA -Deficit Greduction Gact Gof G 2005 -The Gpatient Gprotection Gand Gaffordable Gcare Gact G 2009 -National Gcorrect Gcoding Ginitiative Gof G 1995 G- Gcorrect Ganswers G-HIPAA Which Gof Gthe Gfollowing Gis Gan Gexample Gof Ga Gviolation Gof Gan Gadult Gpatient's Gconfidentiality? -While Greviewing Ga Gclaim, Gthe GCBCS Greads Gthe Gdiagnosis Gbefore Grealizing Gthat Gthe Gpatient Gis Ga Gneighbor -A GCBCS Gqueries Gthe Gphysician Gabout Ga Gdiagnosis Gin Ga Gpatient's Gmedical Grecord -The Gphysician Guses Ghis Ghome Gphone Gto Gdiscuss Gpatient Gcare Gwith Gthe Gnursing Gstaff -Patient Ginformation Gwas Gdisclosed Gto Gthe Gpatient's Gparents Gwithout Gconsent G- Gcorrect Ganswers G-Patient Ginformation Gwas Gdisclosed Gto Gthe Gpatient's Gparents Gwithout Gconsent Which Gof Gthe Gfollowing Gis Gthe Gpurpose Gof Grunning Gan Gaging Greport Geach Gmonth? -If Gindicates Gthe Gbalances Gthe Gpatients Gowe Gthe Gprovider -It Gindicates Gwhich Gpatients Ghave Gupcoming Gor Gmissed Gappointment -It Gindicates Gwhich Gclaims Gare Goutstanding
-It Gindicates Gwhat Gthe Ginsurance Gcompany Ghas Gpaid Gfor Gthe Gprovider's Gservices Gto Ga Gpatient. G- Gcorrect Ganswers G-It Gindicates Gwhich Gclaims Gare Goutstanding Which Gof Gthe Gfollowing Gdescribes Gthe Gstatus Gof Ga Gclaim Gthat Gdoes Gnot Ginclude Gthe Grequired Gpreauthorization Gfor Ga Gservice? -Delinquent G(overdue) -Denied -Suspended -Adjudicated G(claim Gstill Gbeing Gprocessed) G- Gcorrect Ganswers G-Denied -Delinquent G(overdue) -Adjudicated G(claim Gstill Gbeing Gprocessed) Which Gof Gthe Gfollowing Gactions Gshould Gthe GCBCS Gtake Gto Gprevent Gfraud Gand Gabuse Gin Gthe Gmedical Goffice? -Serviced Gprocedure Gpreauthorization -Internal Gmonitoring Gand Gauditing -Utilization Greview -Correct Gcoding Ginitiative G- Gcorrect Ganswers G-Internal Gmonitoring Gand Gauditing In Gan Goutpatient Gsetting, Gwhich Gof Gthe Gfollowing Gforms Gis Gused Gas Ga Gfinancial Greport Gof Gall Gservices Gprovided Gto Gpatients? -Encounter Gform -Patient Gaccount Grecord G -CMS-1500 Gclaim Gform -Accounts Greceivable Gjournal G- Gcorrect Ganswers G-Patient Gaccount Grecord G(patient Gledger, Gall Gtransactions Gbetween Gpatient Gand Gthe Gpractice) -Accounts Greceivable Gjournal G(Day Gsheet G= Gchronological Gsummary Gof Gall Gtransaction Gon Ga Gspecific Gday) Patient Gcharges Gthat Ghave Gnot Gbeen Gpaid Gwill Gappear Gin Gwhich Gof Gthe Gfollowing? -Accounts Greceivable -Accounts Gpayable -Tracer -Rejected Gclaim G- Gcorrect Ganswers G-Accounts Greceivable Which Gof Gthe Gfollowing Gis Gconsidered Gthe Gfinal Gdetermination Gof Gthe Gissues Ginvolving Gsettlement Gof Gan Ginsurance Gclaim? -Processing G -Translation G -Adjudication G -Transmission G- Gcorrect Ganswers G-Adjudication G(process Gof Gputting Ga Gclaim Gthrough Ga Gseries Gof Gedits Gfor Gfinal Gdetermination)
-The Gphysician Gagrees Gto Gbill Gaccording Gthe Gthird Gpayer's Gfee Gschedule -The Gpatient Gagrees Gto Gpay Gthe Gdifference Gbetween Gthe Gbilled Gamount Gand Gthe Gallowed Gamount G- Gcorrect Ganswers G-The Gphysician Gagrees Gto Gaccept Gpayment Gunder Gthe Gterms Gof Gthe Gpayer's Gprogram. Which Gof Gthe Gfollowing Gparts Gof Gthe Gbody Gsystem Gregulates Gimmunity? -Endocrine Gsystem G(regulates Ggrowth, Gmetabolic) -Respiratory Gsystem G(removes Gcarbon Gdioxide) -Urinary Gsystem G(filters Gblood Gto Gremove Gwaste Gof Gcellular Gmetabolism) -Lymphatic Gsystem G- Gcorrect Ganswers G-Lymphatic Gsystem -Endocrine Gsystem G(regulates Ggrowth, Gmetabolic) -Respiratory Gsystem G(removes Gcarbon Gdioxide) -Urinary Gsystem G(filters Gblood Gto Gremove Gwaste Gof Gcellular Gmetabolism) Which Gof Gthe Gfollowing Gsections Gof Gthe Gmedical Grecord Gis Gused Gto Gdetermine Gthe Gcorrect Gevaluation Gand Gmanagement Gcode Gto Guse Gfor Gbilling Gand Gcoding? -Codes Gused Gduring Gprior Gpatient Gvisits -Patient's Ginsurance Gplan -Plan Gof Gcare -History Gand Gphysical G- Gcorrect Ganswers G-History Gand Gphysical A Gpatient Ghas Gmet Ga GMedicare Gdeductible Gof G$150. GThe Gpatient's Gcoinsurance Gis G20%, Gand Gthe Gallowed Gamount Gis G$600. GWhich Gof Gthe Gfollowing Gis Gthe Gpatient's Gout Gof Gpocket Gexpense? -$ -$ -$ -$150 G- Gcorrect Ganswers G-$ Which Gof Gthe Gfollowing Gis Gallowed Gwhen Gbilling Gprocedure Gcodes? -Unbundling Gcodes Gto Gensure Gthat Gall Gmedical Gservices Gwere Greceived Gand Gbilled Gfor -Billing Gusing Gtwo Gdigit GCPT Gmodifiers Gto Gindicate Ga Gprocedure Gas Gperformed Gdiffers Gfrom Gits Gusual Gfive Gdigit Gcode -Billing Gfor Ga Gsurgical Gpackage Gwith Gitemized Gcodes -Referring Gto Gthe GICD Gbook Gfor Gthe Gaccurate Gdescription Gof Gthe Gprocedural Gcode. G- Gcorrect Ganswers G-Billing Gusing Gtwo Gdigit GCPT Gmodifiers Gto Gindicate Ga Gprocedure Gas Gperformed Gdiffers Gfrom Gits Gusual Gfive Gdigit Gcode Which Gof Gthe Gfollowing Gdescribes Gthe Gcontent Gof Ga Gmedical Gpractice Gaging Greport? -An Goverview Gof Gthe Gpractice's Gnet Gworth -An Goverview Gof Gthe Gpractice Gdeposits. -An Goverview Gof Gthe Gpractice's Gdebts
-An Goverview Gof Gthe Gpractice's Goutstanding Gclaims G- Gcorrect Ganswers G-An Goverview Gof Gthe Gpractice's Goutstanding Gclaims Which Gof Gthe Gfollowing Gis Gthe Gcorrect Gterm Gfor Gan Gamount Gthat Ghas Gbeen Gdetermined Gto Gbe Guncollectible? -Discounted Gfee -Bad Gdebt -Financial Ghardship -Professional Gcourtesy G- Gcorrect Ganswers G-bad Gdebt Which Gof Gthe Gfollowing Gis Gthe Gfunction Gof Gthe Grespiratory Gsystem? -Deoxygenating Gblood Gcells -Oxygenating Gblood Gcells -Generating Gred Gblood Gcells -Generating Gwhite Gblood Gcells G- Gcorrect Ganswers G-Oxygenating Gblood Gcells A GCBCS Gneeds Gto Gknow Ghow Gmuch GMedicare Gpaid Gon Ga Gclaim Gbefore Gbilling Gthe Gsecondary Ginsurance. GTo Gwhich Gof Gthe Gfollowing Gshould Gthe Gspecialist Grefer? -Assignment Gof Gbenefits -Medicare Gsummary Gnotice G(how Gmuch Gthe Gprovider Gwas Gbilled Gand Ghow Gmuch Gthe Gpatient Ghas Gto Gpay) -Remittance Gadvice -Coordination Gof Gbenefits G- Gcorrect Ganswers G-remittance Gadvice The Gstandard Gmedical Gabbreviation G"ECG" Grefers Gto Ga Gtest Gused Gto Gassess Gwhich Gof Gthe Gfollowing Gbody Gsystems? -Endocrine Gsystem -Cardiovascular Gsystem -Male Greproductive Gsystem -Respiratory Gsystem G- Gcorrect Ganswers G-Cardiovascular Gsystem Which Gof Gthe Gfollowing Gblocks Gon Gthe GCMS-1500 Gclaim Gform Gis Gused Gto Gbill GICD Gcodes? -24D
-17a -21 G- Gcorrect Ganswers G- -24D G(CPT Gor GHCPCS Gcodes) -22 G(resubmitting Gto GMedicare) -17a Gnot Grequired Which Gof Gthe Gfollowing Gis Gthe Ginitial Gstep Gin Gperceiving Ga Gworker's Gcompensation Gclaim? -First Greport Gof Ginjury
-ECT G(electroconvulsive Gtherapy G- Gto Gtreat Gmajor Gdepression Gthat Gdoes Gnot Grespond Gto Gstandard Gtreatment) -EMG G(electromyography G= Gtest Gand Grecording Gthe Gelectrical Gactivity Gproduced Gskeletal Gmuscles) -EGD G(esophagogastroduodenoscopy G= Gtest Gthat Gexamines Gthe Glining Gof Gthe Gesophagus, Gstomach Gand Gupper Gpart Gof Gthe Gsmall Gintestine) The Gdestruction Gof Glesions Gusing Gcryosurgery Gwould Guse Gwhich Gof Gthe Gfollowing Gtreatments? -Laser Gtreatment -Chemical Gpeel Gtreatment -Cold Gtreatment -Electric Gcurrent Gtreatment G- Gcorrect Ganswers G-Cold Gtreatment On Gthe GCMS-1500 Gclaim Gform, Gblock G 1 Gthrough G 13 Ginclude Gwhich Gof Gthe Gfollowing? -The Gpatient's Gdemographics -The Gprovider's Ginformation G -The Gpatient's Gdiagnosis G -The Gprocedures Gperformed G- Gcorrect Ganswers G-The Gpatient's Gdemographics -The Gprovider's Ginformation G(on Gblocks G25-33) -The Gpatient's Gdiagnosis G(block G21) -The Gprocedures Gperformed G(block G24) Which Gof Gthe Gfollowing Gis Ga Gtype Gof Gclaim Gthat Gwill Gbe Gdenied Gby Gthe Gthird Gparty Gpayer?
-Claims Gthat Gare Gcompleted Gusing Gthe GCMS-1500 Gclaim Gform G- Gcorrect Ganswers G-claim Gsubmitted Gvia Ga Gsecure Gnetwork Which Gof Gthe Gfollowing Gsecurity Gfeatures Gis Grequired Gduring Gtransmission Gof Gprotected Ghealth Ginformation Gand Gmedical Gclaims Gto Gthird Gparty Gpayers? -Unique Gused GIDs Gand Gpasswords -Role Gbased Gaccess Gcontrols -Electronic Gdata Ginterchange -Encryption G- Gcorrect Ganswers G-encryption Which Gof Gthe Gfollowing Gactions Gshould Gthe GCBCS Gtake Gto Geffectively Gmanage Gaccounts Greceivable? -Collect Gpayment Gfrom Gthe Gpatient Gat Gthe Gtime Gof Gservice -Have Gthe Gpatient Gpat Gthe Gbalance Gup Gfront Gand Gwait Gfor Greimbursement -Delay Gsubmission Guntil Gthe Gpatient Gpays Gthe Gdeductible -Ask Gthe Gpatient Gto Gpay Ghalf Gnow Gand Gbill Gthe Ginsurance Gfor Gthe Gbalance G- Gcorrect Ganswers G-Collect Gpayment Gfrom Gthe Gpatient Gat Gthe Gtime Gof Gservice Which Gof Gthe Gfollowing Ginsurance Gcarriers Gis Gconsidered Gthe Gpayer Gof Glast Gresort? -Medicaid -Medicare -TRICARE -Blue Gcross/shield G- Gcorrect Ganswers G-Medicaid Which Gof Gthe Gfollowing Gblocks Gon Gthe GCMS-1500 Gclaim Gform Gis Grequired Gto Gindicate Ga Gworker's Gcompensation Gclaim? 11a 21 10a 22 G- Gcorrect Ganswers G-10a -11a Gprimary Ginjured Gdate Gof Gbirth Gand Ggender -21 Gdiagnosis Gcode G -22 GMedicaid Gresubmission Gnumber The Gprovision Gof Ghealth Ginsurance Gpolicies Gthat Gspecifies Gwhich Gcoverage Gis Gconsidered Gprimary Gor Gsecondary Gis Gcalled? -Eligibility Gverification -Explanation Gof Gbenefits -Assignment Gof Gbenefits -Coordination Gof Gbenefits G- Gcorrect Ganswers G-coordination Gof Gbenefits A Gprovider Greceives Ga Greimbursement Gfrom Ga Gthird Gparty Gpayer Gaccompanied Gby Gwith Gdocument?
15000 G- Gcorrect Ganswers G-150 G 00 Which Gof Gthe Gfollowing Gorganizations Gidentifies Gimproper Gpayments Gmade Gon GCMS Gclaims?
A Gprovider Gperforms Gan Gexamination Gof Ga Gpatient's Gsore Gthroat. GWhich Gof Gthe Gfollowing Gdescribes Gthe Glevel Gof Gthe Gexamination?
Which Gof Gthe Gfollowing Gclaims Gwould Gappear Gon Gan Gaging Greport?