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CBCS Exam Questions & Answers
2022/2023(Verified Answers by Expert)1.What describes the reason for a claim rejection because of Medicare
NCCI edits✔✔✔✔Improper code combinations
2.A claim is submitted with a transposed insurance member ID number
and returned to the provider.✔✔✔✔Invalid
3.Medigap coverage is offered to Medicare beneficiaries by
whom✔✔✔✔Private third-party payers
4.What provision assures that an insured’s benefits from all insurance
com- panies do not exceed 100% of the allowable medical
expense✔✔✔✔Coordination of benefits
5.A coroner’s autopsy is comprised of what examination✔✔✔✔Gross
Examination
6.What is true regarding the release of a patient records✔✔✔✔Patient
access to psychotherapy notes is restricted
7.What is considered fraud✔✔✔✔Billing for services not provided
8.What component of an explanation of benefit expedites the process of
a phone appeal✔✔✔✔Claim control number
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9.On the CMS-1500 claim form, item number 14 – 33 contain
information about✔✔✔✔The patient’s condition and the provider’s
information
10.The financial record source that is generated by a provider’s office
is called a✔✔✔✔Patients ledger account
11.A medical term refers to the sac that encloses the
heart✔✔✔✔Pericardium
12.HIPPA transaction standards apply to which entities✔✔✔✔Health care
clearing- houses
13.All dependents 10 yrs of age or older are required to have what
for TRICARE✔✔✔✔Military identification
14.The standard medical abbreviation ” ECG ” refers to a test used to
assess what body system✔✔✔✔Cardiovascular system
15.Claims that are submitted without an NPI number will delay payment
to the provider because✔✔✔✔It is used as a preauthorization number
16.An example of a violation of patient confidentiality✔✔✔✔A billing
and coding specialist queries the physician about a diagnosis in a
patient’s medical record
17.What section of the medical record is used to determine the correct
E&M code used for billing and coding✔✔✔✔History and Physical
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18.What action should be taken if an insurance company denies a
service as not medically necessary✔✔✔✔Appeal the decision with a
provider’s report
19.What is the name of the portion of the account balance for which the
patient id responsible after service have been rendered and the yearly
de- ductible has been met✔✔✔✔Coinsurance
20.What is the function of the respiratory system✔✔✔✔Oxygenating
blood cells
21.What describes a delinquent claim✔✔✔✔The claim is overdue for
payment
22.What action should taken if he or she observes a colleague in an unethical situation✔✔✔✔Report the incident to a supervisor
23.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.
They paid the balance at 80%. How much should the patient expect to
pay✔✔✔✔$48
24.What statement is correct regarding a deductible✔✔✔✔The
deductible is the patient’s responsibility
25.A physician ordered a comprehensive metabolic panel for a 70-yr old
pa- tient who has Medicare as her primary insurance. What forms is
required so the patient knows she may be responsible for
payment✔✔✔✔Advanced Beneficiary Notice