NHA CBCS Exam Prep Questions & Answers 2023/2024
What actions should be taken when a claim is billed for a level four office visit and paid at a level three? - ANSWER-Submit an appeal with documentation
The standard medical abbreviation "ECG" refers to a test used to assess which of the bod...
What actions should be taken when a claim is billed for a level four office visit and paid at a level three? -
ANSWER-Submit an appeal with documentation
The standard medical abbreviation "ECG" refers to a test used to assess which of the body systems? -
ANSWER-cardiovascular system- test checks electricity of heart
According to HIPAA standards, what identifies the rendering provider on the CMS-1500 claim form in
Block 24J? - ANSWER-NPI
On the CMS-1500 claim form, blocks 14 through 33 contain information about? - ANSWER-The patient's
condition and the provider's information
Which block should the BCS complete on the CMS-1500 form for procedures, services, or supplies? -
ANSWER-24D
Which term describes when a plan pays 70% of the allowed and the patient pays 30%? - ANSWER-
Coinsurance is a percentage of the cost for covered services that is approved by the insurance company
A provider charges $500 to a claim that had an allowable amount of $400. What should happen to the
non-allowed charge? - ANSWER-Write Off or adjustment
Patient: Justin Austin; Social Security NO.: 555-22-1111; Medicare ID NO.: 555-33-2222A; DOB:
05/22/1945. Claim information entered: Austin, Jane; Social Security No.: 555-22-111; Medicare ID No.:
555-33-2222A; DOB: 052245. What is a reason the claim was rejected? - ANSWER-The DOB is entered
incorrectly - the format is two digits for the month and four digits for the year.
A patient's health plan is referred to as the "payer of last resort." The patient is covered by which health
plan? - ANSWER-Medicaid
, 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 what? -
ANSWER-Deductible
Ambulatory surgery centers, home health care, and hospice organizations use what form? - ANSWER-UB-
04 Form
A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has Medicare as her
primary insurance. Which form is required so the patient knows she may be responsible for payment? -
ANSWER-Advanced Beneficiary Notice is a form that is required for Medicare recipients
Which of the following should the BCS complete to be reimbursed for the provider's services? -
ANSWER-CMS-1500 claim form
What is the maximum number of diagnoses that can be reported on the CMS-1500 claim form before a
further claim is required? - ANSWER-12
Describe a delinquent claim? - ANSWER-It is considered delinquent when it is overdue for payment, 120
days or older
What are considered proper supportive documentation for reporting CPT and ICD codes for surgical
procedures? - ANSWER-Operative reports are required to support surgical procedures
When submitting a clean claim with a diagnosis of kidney stones, which of the following procedure
names is correct? - ANSWER-Nephrolithiasis The destruction of kidney stones
The BCS should first divide the e/m code by which of the following? - ANSWER-Place of service which
narrows down the specific code as one of the three deciding factors
Appeal the decision with a provider's report - ANSWER-Which of the following actions should be taken if
an insurance company denies a service as not medically necessary?
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Bensuda. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $8.99. You're not tied to anything after your purchase.
