CPB Exam Questions - Certified Professional Biller (CPB) Test Questions & CPB Test Guide
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| Section | Weight | Objectives |
|---|
| Types of Insurance | 21% | - Managed care plans - TRICARE/CHAMPUS, Workers' compensation - Third-party liability - Medicare, Medigap, Medicaid - Commercial payers
|
| Claims and Billing | 14% | - Electronic claims, clearinghouses - Timely filing rules - Claim submission, tracking, follow-up - Denials, appeals, corrections
|
| Reimbursement and Collections | 14% | - Payment posting, adjustments - Accounts receivable management - Refunds, payment plans, write-offs - Patient statements, collections
|
| Coding Concepts for Billers | 12% | - Code validation, modifiers - ICD-10-CM, CPT®, HCPCS Level II - Medical necessity
|
| HIPAA and Compliance | 9% | - Medical record retention - Privacy, security, transaction standards - Fraud, abuse, False Claims Act - Compliance programs
|
| Billing Regulations | 13% | - ACOs, NCCI, LCDs, NCDs - Payer payment policies - Incident-to billing, global packages - CMS-1500, UB-04 completion
|
| Case Analysis | 17% | - Adjudication and resolution - End-to-end billing scenarios - Eligibility verification
|
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AAPC Certified Professional Biller (CPB) Sample Questions (Q130-Q135):
NEW QUESTION # 130
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- A. skin
- B. right
- C. half
- D. lack of, down
Answer: D
NEW QUESTION # 131
Bonding insurance is an insurance agreement that guarantees repayment for financial losses resulting from the act or failure to act of an employee. It protects the financial operations of the employer.
Answer: A
NEW QUESTION # 132
Which term refers to a digital version of a patient's paper chart, encompassing a comprehensive record of patient health information?
- A. Early and Periodic screening, diagnostic, and treatment
- B. Electronic Medical Record
- C. Explanation of Benefits
- D. Exclusive provider organization
Answer: B
NEW QUESTION # 133
What is the provider's responsibility when a patient has a copayment?
- A. Waive it routinely
- B. Write it off automatically
- C. Collect it at the time of service
- D. Bill it to insurance
Answer: C
Explanation:
Copayments are patient responsibility and should be collected at the time of service.
NEW QUESTION # 134
ASC (Choose two.)
- A. Ambulatory Surgical Center
- B. Blue Cross
- C. Beneficiary Counseling and Assistance Coordinator
- D. Accredited Standards Committee
Answer: A,D
NEW QUESTION # 135
......
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