NHA CBCS Exam (2024/ 2025) | Questions and Verified Answers| 100% Correct| A Grade
QUESTION
The physician bills $500 to a patient. After submitting
... [Show More] 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
Answer:
Deductible
QUESTION
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 HIPAA violation?
Answer:
The billing and coding specialist sends the patient's records to the patient's partner.
QUESTION
A patient is upset about a bill she received. Her insurance company denied the claim. Which of the following actions is an appropriate way to handle the situation?
Answer:
Inform the patient of the reason of the denial
QUESTION
A patient presents to the provider with chest pain and SOB. 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?
Answer:
TITLE II
QUESTION
A physician ordered a comprehensive metabolic panel for a 70 year old patient who has Medicare as her primary insurance. Which of the following forms is required so the patient knows she may be responsible for payment?
Answer:
Advanced Beneficiary Notice
QUESTION
Which of the following describes the reason for a claim rejection because of Medicare NCCI edits?
Answer:
Improper code combinations
QUESTION
Which of the following is the purpose of running an aging report each month?
Answer:
It indicates which claims are outstanding
QUESTION
Which of the following do physicians use to electronically submit claims?
Answer:
Clearinghouses
QUESTION
Which of the following should the billing and coding specialist include in an authorization to release information?
Answer:
The entity to whom the information is to be released
QUESTION
Which of the following information is required on a patient account record?
Answer:
Name and address of guarantor
QUESTION
Which of the following forms should the billing and coding specialist transmit to the insurance carrier for reimbursement of inpatient hospital services?
Answer:
UB-04
QUESTION
An insurance claims register (aged insurance report) facilitates which of the following?
Answer:
Follow up of insurance claims by date
QUESTION
When posting payment accurately, which of the following items should the billing and coding specialist include?
Answer:
Patient's responsibility
QUESTION
Which of the following should the billing and coding specialist complete to be reimbursed for the provider's services?
Answer:
CMS-1500 claim form
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