{"id":121727,"date":"2023-10-26T18:57:27","date_gmt":"2023-10-26T18:57:27","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=121727"},"modified":"2023-10-26T18:57:33","modified_gmt":"2023-10-26T18:57:33","slug":"cbcs-exam-study-guide-questions-and-answers-2023-2024-verified-answers-cbcs-exam-study-guide-questions-and-answers-2023-2024-verified-answers","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/10\/26\/cbcs-exam-study-guide-questions-and-answers-2023-2024-verified-answers-cbcs-exam-study-guide-questions-and-answers-2023-2024-verified-answers\/","title":{"rendered":"CBCS Exam Study Guide Questions and Answers (2023 \/ 2024) (Verified Answers) CBCS Exam Study Guide Questions and Answers (2023 \/ 2024) (Verified Answers)"},"content":{"rendered":"\n

1 \/ 29
CBCS Exam Study Guide<\/p>\n\n\n\n

    \n
  1. Medical Billing & Coding as a Career: *Claims assistant professional or claimsmanager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor,
    *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Billing & Coding Specialist<\/li>\n\n\n\n
  2. What are Medical Ethics?: Standards of conduct based on moral principle.Theyare generally accepted as a guide for behavior towards pt’s, dr’s, co-workers, the
    gov, and ins co’s.<\/li>\n\n\n\n
  3. What does acting within ethical behavior boundaries mean?: carrying out
    one’s responsibilities w\/ integrity, dignity, respect, honesty, competence, fairness, &trust.<\/li>\n\n\n\n
  4. Compliance regulations:: Most billing-related cases are based on HIPPA and
    False Claims Act<\/li>\n<\/ol>\n\n\n\n

    2 \/ 29<\/p>\n\n\n\n

      \n
    1. Health Insurance Portability & Accountability Act (HIPPA): Enacted in 1996,created by the Health Care Fraud & Abuse Control Program-enacted to check for
      fraud and abuse in the Medicare\/Medicaid Programs and private payers<\/li>\n\n\n\n
    2. What are the 2 provisions of HIPPA?: Title I: Insurance Reform
      Title II: Administrative Simplification<\/li>\n\n\n\n
    3. What is Title I of HIPPA?: Insurance Reform-primary purpose is to provide continuous ins coverage for worker & their dependents when they change or lose jobsAlso *Limits the use of preexisting conditions exclusions *Prohibits discrimination
      from past or present poor health *Guarantees certain employees\/indv the right to
      purchase new health ins coverage after losing job *Allows renewal of health ins covregardless of an indv’s health cond. that is covered under the particular policy.<\/li>\n\n\n\n
    4. What is Title II of HIPPA?: Administrative Simplification-goal is to focus on the
      health care practice setting to reduce administrative cost & burdens. Has 2 parts- 1)development and implementation of standardized health-related financial & administrative activities electronically 2) Implementation of privacy & security proceduresto prevent the misuse of health info by ensuring confidentiality<\/li>\n\n\n\n
    5. What is the False Claims Act (FCA)?: Federal law that prohibits submitting a
      fraudulent claim or making a false statement or representation in connection w\/ a
      claim. Also protects & rewards whistle-blowers.<\/li>\n<\/ol>\n\n\n\n

      3 \/ 29<\/p>\n\n\n\n

        \n
      1. What is the National Correct Coding Initiative (NCCI)?: Developed by CMSto promote the national correct coding methodologies & to control improper codingthat lead to inappropriate payment of Part B health ins claims.<\/li>\n\n\n\n
      2. How many edits does NCCI include?: 2: 1)Column 1\/Column 2 (prev called
        Comprehensive\/Component) Edits
        2) Mutually Exclusive Edits<\/li>\n<\/ol>\n\n\n\n

        4 \/ 29<\/p>\n\n\n\n

          \n
        1. Column 1\/Column 2 edits (NCCI): Identifies code pairs that should not be billedtogether b\/c 1 code (Column 1) includes all the services described by another code(Column 2)<\/li>\n\n\n\n
        2. Mutually Exclusive Edits (NCCI): ID’s code pairs that, for clinical reasons, areunlikely to be performed on the same pt on the same day<\/li>\n\n\n\n
        3. What are the possible consequences of inaccurate coding and incorrect
          billing?: *delayed processing & payment of claims *reduced payments, denied
          claims *fine and\/or imprisonment *exclusion from payer’s programs, loss of dr’s
          license to practice med<\/li>\n\n\n\n
        4. Who has the task of investigate and prosecuting health care fraud &
          abuse?: The Office of Inspector General (OIG)<\/li>\n\n\n\n
        5. Fraud: knowingly & intentionally deceiving or misrepresenting info that may
          result in unauthorized benefits. It is a felony and can result in fines and\/or prison.<\/li>\n\n\n\n
        6. Who audits claims?: State & federal agencies as well as private ins co’s<\/li>\n\n\n\n
        7. What are common forms of fraud?: billing for services not furnished, unbundling, & misrepresenting diagnosis to justify payment
          <\/li>\n<\/ol>\n\n\n\n
          \"\"\/<\/figure>\n\n\n\n
          \"\"<\/figure>\n","protected":false},"excerpt":{"rendered":"

          1 \/ 29CBCS Exam Study Guide 2 \/ 29 3 \/ 29 4 \/ 29<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-121727","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/121727","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=121727"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/121727\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=121727"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=121727"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=121727"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}