NHA CBCS Exam (New 2024/ 2025 Update) | Questions and Verified Answers| 100% Correct| A Grade
QUESTION
Which of the following formats are used to
... [Show More] submit electronic claims to a third-party payer?
Answer:
837
QUESTION
Urine moved from the kidneys to the bladder through which of the following parts of the body?
Answer:
Ureters
QUESTION
As of April 1, 2014, 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
QUESTION
Which of the following does a patient sign to allow payment of claims directly to the provider?
Answer:
Assignment of benefits
QUESTION
Which of the following is the primary function of the heart?
Answer:
Pumping blood in the circulatory system
QUESTION
Which of the following is true regarding Medicaid eligibility?
Answer:
Patient eligibility is determined monthly
QUESTION
The explanation of benefits states the amount billed was $80. The allowed amount is $60, and the patient is required to pay a $20 copayment. Which of the following describes the insurance check amount to be posted?
Answer:
$40
QUESTION
Which of the following provisions ensures that an insured's benefits from all insurance companies do not exceed 100% of allowable medical expenses?
Answer:
Coordination of benefits
QUESTION
If a clean claim is received on March 1 of this year, which of the following is the allowable last day of payment in order to meet Medicare compliance requirements?
Answer:
March 30
QUESTION
On a remittance advice form, which of the following is responsible for writing off the difference between the amount billed and the amount allowed by the agreement?
Answer:
Provider
QUESTION
Which of the following is the maximum number of modifiers that the billing and coding specialist can report on a CMS-1500 claim form in Block 24D?
Answer:
4
QUESTION
When the remittance advice is sent from the third-party payer to the provider, which of the following actions should the billing and coding specialist perform first?
Answer:
Ensure proper payment has been made
QUESTION
Which of the following is a reason a claim would be denied?
Answer:
Incorrectly linked codes
QUESTION
The billing and coding specialist should follow the guidelines in the CPT manual for which of the following reasons?
Answer:
The guidelines define items that are necessary to accurately code
QUESTION
Which of the following documentation is a valid authorization to release medical information to the judicial system?
Answer:
Subpoena duces tecum
QUESTION
A claim is denied due to termination of coverage. Which of the following actions should the billing and coding specialist take next?
Answer:
Follow up with the patient to determine current name, address, and insurance carrier for resubmission
QUESTION
A patient who has a primary malignant neoplasm of the lung should be referred to which of the following specialists?
Answer:
Pulmonary oncologist
QUESTION
Which of the following is a HIPAA compliance guideline affecting electronic health records?
Answer:
The electronic transmission and code set standards require every provider to use the healthcare transactions, code sets, and identifiers [Show Less]