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AAPC CPB FINAL EXAM NEWEST ACTUAL
EXAM COMPLETE 250 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+|BRAND
NEW!!Below are the QUESTIONs and Answers derived from the provided text about healthcare regulations, privacy rules, billing practices, and insurance-related concepts in the United States.Each response is presented in a clear QUESTION-and-Answer format, using the exact information provided without adding external details, per your instructions. Every term, definition, and number (e.g., "12" national priority purposes, "60" days for Medicare overpayment returns) is preserved as given, and the Answers are organized alphabetically by topic for clarity.
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### Billing and Claims Processing
QUESTION: What action should be taken when a request for
medical records is received from a patient's insurance company for a specific date of service regarding a submitted claim, with no authorization provided?
Answer: Release reqt to ins co A request for medical records is
received for a specific date of service from patient's insurance company with regards to a submitted claim. No authorization
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for release of information is provided. What action should be taken?
QUESTION: Does an office have to notify the patient or have
them sign a release to send medical records to a health plan adjudicating a claim?
Answer: no A health plan sends a request for medical records in
order to adjudicate a claim. Does the office have to notify the patient or have them sign a release to send the information? no
QUESTION: What regulation applies if a practice sets up a
payment plan with a patient for more than four installments, making the practice a creditor?
Answer: Truth in Lending Act A practice sets up a payment plan
with a patient. If more than four installments are extended to the patient, what regulation is the practice subject to that makes the practice a creditor? Truth in Lending Act
QUESTION: What is the purpose of the standard CMS-1500
claim form?
Answer: pro services for phys What is the purpose of the
standard CMS-1500 claim form? pro services for phys
QUESTION: What is the UB-04 claim form also called?
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Answer: CMS 1450 The UB-04 claim form is also called: CMS 1450
QUESTION: What type of code reports the event(s) related to
the billing period on the UB-04 claim form?
Answer: occurrence codes What type of code reports the
event(s) related to the billing period on the UB-04 claim form?occurrence codes
QUESTION: When is FL 35 and FL 36 used on the UB-04
claim form to identify occurrence span code and dates?
Answer: inpt services FL 35 and FL 36 are used on the UB-04
claim form to identify occurrence span code and dates. When is this section completed? inpt services
QUESTION: What punctuation should be used when entering
the patient's name on the CMS-1500 claim form?
Answer: comma When entering the patient's name on the CMS-
1500 claim form, what punctuation should be used? comma
QUESTION: What is used to indicate an inpatient service is
reported on an outpatient claim?
Answer: condition code A ___ is used to indicate an inpatient
service is reported on an outpatient claim. condition code
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QUESTION: What does "accepting assignment" mean in
billing?
Answer: accepting assignment The provider accepts a
contractual write-off of the difference between the charged amount and the allowed amount. accepting assignment
QUESTION: What does adjudication mean in the claims
process?
Answer: adjudication Determination of the insurer's payment
amount after the member's insurance benefits have been applied.adjudication
QUESTION: Who is the provider with overall responsibility for
the patient's medical care during hospitalization?
Answer: attending ___ provider with overall responsibility for
the patient's medical care during hospitalization. attending
QUESTION: What is the correct format to enter the date of birth
on a paper CMS-1500 claim form?
Answer: MMDDCCYY Identify the correct format to enter the
date of birth on a paper CMS-1500 claim form MMDDCCYY
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