CPB Sample Questions & Answers
The largest share goes to case analysis and complex billing situations, followed by insurance types spanning government and commercial plans, coding compliance checks, fraud and HIPAA safeguards, reimbursement, claims coordination, and procedural and diagnosis coding.
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- Question 1Intermediate
What are actions inconsistent with accepted, sound medical business or fiscal practice? A.AbuseB.ViolenceC.AddictionD.Neglect
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Correct answer: A
- Question 2Intermediate
FPL A.Federal RegisterB.Flexible Spending AccountC.General Equivalency MappingD.Federal Poverty Level
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Correct answer: D
- Question 3Intermediate
Allowable Charge A.The Maximum amount the payer will reimburse for each procedure or service, according to the patients policy.B.DRG system adapted for use by thirdparty payers to reimburse hospitals for inpatient care provided to nonMedicare beneficiaries (e.g. Blue Cross Blue Shield, commercial health plans, TRICARE); DRG assignment is based on intensity of resources.C.See limiting charge; maximum fee a physician may charge.D.Adopted by Medicare in 2008 to reimburse hospitals for inpatient care provided to Medicare beneficiaries; expanded original DRG system (based on intensity of resources) to add two subclasses to each DRG that adjusts Medicare inpatient hospital reimbursement rates for of mortality (ROM) (likelihood of dying); each subclass, in turn, is subdivided into four areas: (1) minor, (2) moderate, (3) major, (4) extreme.
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Correct answer: C
- Question 4Intermediate
Ambulatory Surgical Center (ASC) includes State Licensed Medicare-certified supplier (not provider) of surgical healthcare services that must accept assignment on Medicare Claims. A.TRUEB.FALSE
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Correct answer: A
- Question 5Intermediate
What does ANSI stand for? A.American National Standards InstituteB.American National Services InstituteC.American National Standards InformationD.American National Services Information
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Correct answer: A
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