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| Section | Weight | Objectives |
|---|---|---|
| Coding Concepts for Billers | 12% | - Code validation, modifiers - ICD-10-CM, CPT®, HCPCS Level II - Medical necessity |
| Types of Insurance | 21% | - Third-party liability - Medicare, Medigap, Medicaid - Managed care plans - Commercial payers - TRICARE/CHAMPUS, Workers' compensation |
| Reimbursement and Collections | 14% | - Patient statements, collections - Refunds, payment plans, write-offs - Payment posting, adjustments - Accounts receivable management |
| Billing Regulations | 13% | - Incident-to billing, global packages - Payer payment policies - CMS-1500, UB-04 completion - ACOs, NCCI, LCDs, NCDs |
| HIPAA and Compliance | 9% | - Medical record retention - Fraud, abuse, False Claims Act - Compliance programs - Privacy, security, transaction standards |
| Claims and Billing | 14% | - Denials, appeals, corrections - Claim submission, tracking, follow-up - Electronic claims, clearinghouses - Timely filing rules |
| Case Analysis | 17% | - Eligibility verification - End-to-end billing scenarios - Adjudication and resolution |
Most of the candidates who plan to take the CPB certification exam lack updated practice questions to ace it on the first attempt. Due to this, they fail the Certified Professional Biller (CPB) (CPB) test, losing money and time. And in some cases, applicants fail on the second attempt as well because they don't prepare with CPB Actual Exam questions. This results in not only the loss of resources but also the motivation of the candidate.
NEW QUESTION # 138
What does it mean by dis?
Answer: A
NEW QUESTION # 139
What is Blue Cross (BC)?
Answer: D
NEW QUESTION # 140
What is the main purpose of an audit in medical billing?
Answer: C
Explanation:
Audits are used to verify accurate billing practices and ensure compliance with regulations.
NEW QUESTION # 141
FEHBP stands for Federal Employee Health Benefit Program.
Answer: B
NEW QUESTION # 142
CMS
Answer: D
NEW QUESTION # 143
......
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