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NHA CBCS EXAM REVIEW LATEST UPDATE 2024 -2025
/ ACTUAL EXAM QUESTIONS WITH CORRECT
VERIFIED ANSWERS/ GRADED A+
Which of the following is the purpose of coordination of benefits? - Correct Answer - Prevent multiple insurers from paying benefits covered by other policies
A billing and coding specialist submitted a claim to Medicare electronically. No errors were found by the billing software or clearinghouse. Which of the following describes this claim? - Correct Answer - Clean claim
Which of the following qualifies as an exception to the HIPAA Privacy Rule? - Correct Answer - Psychotherapy notes
Which of the following would result in a claim being denied? - Correct Answer - An italicized code used as the first listed diagnosis
Which of the following standardized formats are used in the electronic filing of claims? - Correct Answer - HIPAA standard transactions
Which of the following describes a two-digit CPT code used to indicate that the provider supervised an interpreted a radiology procedure? - Correct Answer - Professional component
The function of the respiratory system? - Correct Answer - Oxygenating blood cells
What medical term refers to the sac that enclosed the heart? - Correct Answer - Pericardium
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pg. 2 Medigap coverage is offered to Medicare beneficiaries by? - Correct Answer - Private third-party payers
One of the purposes of an internal auditing program in a physician's office? - Correct Answer - Verifying that the medical records and the billing record match
On the CMS-1500 claim form, Block 1 through 13 include? - Correct Answer - The patient's demographics
A patient presents to the provider with chest pain and shortness of breath. After an unexpected ECG result, the provider calls a cardiologist and summarizes the patient's symptoms. What portion of HIPAA allows the provider to speak to the cardiologist prior to obtaining the patient's consent? - Correct Answer - Title II
A patient's employer has not submitted a premium payment. What claim status should the provider receive from the third-party payer? - Correct Answer - Denied
A patient's health plan is referred to as the "payer of last resort." The patient is covered what health plan? - Correct Answer - Medicaid
A patient's upset about a bill she received. Her insurance company denied the claim.What action is an appropriate way to handle the situation? - Correct Answer - Inform the patient of the reason for the denial
A patient with a past due balance requests that his records be sent to another provider.What action should be taken? - Correct Answer - Accommodate the request and send the records
The physician bills $500 to a patient. After submitting the claim to the insurance company, the claim is sent back with no payment. The patient still owes $500 for the year. This amount is called? - Correct Answer - Deductible
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pg. 3 A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has Medicare as her primary insurance. This form is required so the patient knows she may be responsible for payment? - Correct Answer - Advance Beneficiary Notice
A provider charged $500 to a claim that had an allowable amount of $400. In which of the following columns should the billing and coding specialist apply the non-allowed charge? - Correct Answer - Adjustment column of the credits
Sections of the medical record used to determine the correct Evaluation and Management code used for billing and coding? - Correct Answer - History and Physical
The symbol "O" in the Current Procedural Terminology reference is used to indicate which of the following? - Correct Answer - Reinstate or recycled code
This block requires the patient's authorization to release medical information to process a claim? - Correct Answer - Block 12
This describes an obstruction of the urethra? - Correct Answer - Urethratresia
This includes procedures and best practices for correct coding? - Correct Answer - Coding Compliance Plan
This indicates a claim should be submitted on paper instead of electronically? - Correct Answer - The claim requires an attachment
This privacy measure ensures protected health information (PHI). - Correct Answer - Using data encryption software on office workstations
This provision ensures that an insured's benefits from all insurance companies does not exceed 100% of allowable medical expenses? - Correct Answer - Coordination of benefits
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