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NHA CBCS CERTIFICATION EXAM Expected Questions and Verified Answers 100% Guarantee Pass NHA CBCS CERTIFICATION EXAM Expected Questions and Verified Answers 100% Guarantee Pass NHA CBCS CERTIFICATION EXAM Expected Questions and Verified Answers 100% Guarantee Pass
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1 / 13 1.Which of the following is considered the final determination of the issues involving settlement of an insurance claim? Ans>> Adjudication 2.A form that contains charges, DOS, CPT codes, ICD codes, fees and copay- ment information is called which of the following? Ans>> Encounter form 3.A patient comes to the hospital for an inpatient procedure. Which of the following
2 / 13 hospital staff members is responsible for the initial patient interview, obtaining demographic and insurance information, and documenting the chief complaint? Ans>> Admitting clerk 4.Which of the following privacy measures ensures protected health informa- tion (phi)? Ans>> Using data encryption software on office workstations 5.Which of the following planes divides the body into left and right? Ans>> Sagittal 6.Which of the following provisions ensures that an insured's benefits from all insurance companies do not exceed 100% of allowable medical expens- es? Ans>> Coordination of benefits
4 / 13 11.Which of the following actions by a billing and coding specialist would be considered fraud? Ans>> Billing for services not provided 12.The >< symbol is used to indicate a new and revised test other than which of the following? Ans>> Procedure descriptors 13.On the CMS-1500 claim form, blocks 14 through 33 contain information about which of the following? Ans>> The patient's condition and the provider's informa- tion 14.Which of the following includes procedures and best practices for correct coding? Ans>> Coding Compliance Plan
5 / 13 15.When completing a CMS-1500 paper claim form, which of the following is an acceptable action for the billing and coding specialist to take? Ans>> Use arial size 10 font 16.A participating blue cross/blue shield (BC/BS) provider receives an expla- nation of benefits for a patient account.The charged amount was $100. BC/BS allowed $ and applied $40 to the patient's annual deductible. BC/BS paid the balance at 80%. How much should the patient expect to pay? Ans>> $
7 / 13 Ans>> The electronic transmission and code set standards require every provider to use the
8 / 13 healthcare transactions ,code sets and identifiers 23.Why does correct claim processing rely on accurately completed en- counter forms? Ans>> They streamline patient billing by summarizing the services ren- dered for a given date of service 24.A patient's health plan is referred to as the "payer of last resort." The patient is covered by which of the following health plans? Ans>> Medicaid 25.Which of the following color formats is acceptable on the CMS-1500 claim form? Ans>> Red 26.Which of the following is an example of a violation of an adult patient's confidentiality? Ans>> Patient information was disclosed to the patient's parents without consent. 27.In the anesthesia section of the CPT manual, which of the following are considered qualifying circumstances? Ans>> Add-on codes 28.Ambulatory surgery centers, home health care, and hospice organizations use the Ans>> UB-04 claim form 29.Which of the following is a private insurance carrier?
10 / 13 31.Which of the following is one of the purposes of an internal auditing program in a physician's office? Ans>> Verifying that the medical records and the billing record match 32.The star symbol in the CPT code book is used to indicate which of the following? Ans>> Telemedicine 33.Medigap coverage is offered to Medicare beneficiaries by which of the following? Ans>> Private third party payers 34.A patient's portion of the bill should be discussed with the patient before a procedure is performed for which of the following reasons? Ans>> To ensure the patient understands his portion of the bill 35.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 this year. This amount is called Ans>> Deductible 36.A patient who is an active member of the military recently returned from overseas and is in need of specialty care. The patient does not have anyone designated with power of attorney. Which of the following is considered a
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13 / 41.Which of the following is the purpose of running an aging report each
14 / month? Ans>> It indicates which claims are outstanding 42.Which of the following do physicians use to electronically submit claims?- Ans>> Clearinghouses 43.Which of the following should the billing and coding specialist include in an authorization to release information? Ans>> The entity to whom the information is to be released
16 / Ans>> Urethra- tresia 51.Which of the following options is considered proper supportive documen- tation for reporting CPT and ICD codes for surgical procedures? Ans>> Operative report 52.Which of the following describes a delinquent claim? Ans>> The claim is overdue for payment 53.All dependents 10 year of age or older are required to have which of the following for TRICARE? Ans>> Military identification 54.Which of the following types of claims is 120 days old? Ans>> Delinquent 55.HIPAA transaction standards apply to which of the following entities? Ans>> - Health care clearinghouse 56.Which of the following actions should be taken when a claim is billed for a level four office visit and paid at a level three? Ans>> Submit an appeal to the carrier with supporting documentation 57.When submitting a clean claim with a diagnosis of kidney stones, which of the following procedure names is correct?
17 / Ans>> Nephrolithiasis 58.All e-mail correspondence to a third party payer containing patients' pro- tected health information (PHI) should be Ans>> Encrypted 59.The billing and coding specialist should divide the evaluation and manage- ment code by which of the following? Ans>> Place of service 60.In which of the following departments should a patient be seen for psori- asis? Ans>> Dermatology 61.A nurse is reviewing a patient's lab results prior to discharge and discovers an elevated glucose level.Which of the following health care providers should
19 / 67.A patient's employer has not submitted a premium payment. Which of the
20 / following claim statuses should the provider receive from the third-party payer? Ans>> Denied 68.Which of the following blocks requires the patient's authorization to re- lease medical information to process a claim? Ans>> Block 12 69.The unlisted codes can be found in which of the following locations in the CPT manual? Ans>> Guidelines prior to each section 70.Which of the following is the portion of the account balance the patient must pay after services are rendered and the annual deductible is met? Ans>> Coin- surance 71.When coding on the UB-04 form, the billing and coding specialist must sequence the diagnosis codes according to the ICD guidelines. Which of the following is the first listed diagnosis code? Ans>> Principal diagnosis 72.Which of the following actions by the billing and coding specialists pre- vents fraud? Ans>> Performing periodic audits 73.Which of the following does a patient sign to allow payment of claims
