NHA CBCS CERTIFICATI ON

• | Page

NHA CBCS CERTIFICATI ON

GRADED A+

Question 1: Which of the following is considered the final

determination of the issues involving settlement of an insurance claim?

CORRECT ANSWER: Adjudication

Question 2: A form that contains charges, DOS, CPT

codes, ICD codes, fees and copayment information is called which of the following?

CORRECT ANSWER: Encounter form

Question 3: A patient comes to the hospital for an

inpatient procedure. Which of the following hospital staff members is responsible for the initial patient interview, obtaining demographic and insurance information, and documenting the chief complaint?

CORRECT ANSWER: Admitting clerk

• | Page

Question 4: Which of the following privacy measures

ensures protected health information (PHI)?

CORRECT ANSWER: Using data encryption software

on office workstations

Question 5: Which of the following planes divides the

body into left and right?

CORRECT ANSWER: Sagittal

Question 6: Which of the following provisions ensures

that an insured's benefits from all insurance companies do not exceed 100% of allowable medical expenses?

CORRECT ANSWER: Coordination of benefits

Question 7: Which of the following actions should be

taken first when reviewing a delinquent claim?

CORRECT ANSWER: Verify the age of the account

Question 8: Which of the following is the advantage of

electronic claim submission?

• | Page

CORRECT ANSWER: Claims are expedited

Question 9: Which of the following components of an

explanation of benefits expedites the process of a phone appeal?

CORRECT ANSWER: Claim control number

Question 10: The standard medical abbreviation ECG

refers to a test used to assess which of the following body systems?

CORRECT ANSWER: Cardiovascular system

Question 11: Which of the following actions by a billing

and coding specialist would be considered fraud?

CORRECT ANSWER: Billing for services not provided

Question 12: The >< symbol is used to indicate a new and

revised test other than which of the following?

CORRECT ANSWER: Procedure descriptors

• | Page

Question 13: On the CMS-1500 claim form, blocks 14

through 33 contain information about which of the following?

CORRECT ANSWER: The patient's condition and the

provider's information

Question 14: Which of the following includes procedures

and best practices for correct coding?

CORRECT ANSWER: Coding Compliance Plan

Question 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?

CORRECT ANSWER: Use Arial size 10 font

Question 16: A participating Blue Cross/Blue Shield

(BC/BS) provider receives an explanation of benefits for a patient account. The charged amount was $100. BC/BS allowed $80 and applied $40 to the patient's annual deductible. BC/BS paid the balance at 80%. How much should the patient expect to pay?