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| Section | Objectives |
|---|
| Topic 1: Insurance Processing and Payer Rules | - Private insurance policies and contracts - Coordination of benefits (COB) - Medicare and Medicaid guidelines
|
| Topic 2: Coding and Claim Submission Basics | - Use of modifiers and coding compliance - Claims submission processes - ICD-10-CM, CPT, and HCPCS overview
|
| Topic 3: Revenue Cycle Management | - Accounts receivable follow-up - Claims denial and rejection management - Payment posting and reconciliation
|
| Topic 4: Medical Billing Fundamentals | - Medical billing workflow and revenue cycle - Healthcare reimbursement systems - Insurance types and payer structures
|
| Topic 5: Compliance and Regulations | - Fraud and abuse prevention - Billing compliance standards - HIPAA and patient privacy rules
|
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AAPC Certified Professional Biller (CPB) Sample Questions (Q200-Q205):
NEW QUESTION # 200
Which amount is written off when a provider is contracted with an insurance company?
- A. Deductible
- B. Contractual adjustment
- C. Copayment
- D. Allowed amount
Answer: B
Explanation:
Contractual adjustments are the differences between billed charges and allowed amounts.
NEW QUESTION # 201
HPSA stands for Health Personnel Shortage Area.
Answer: B
NEW QUESTION # 202
CMS1500
- A. Clinical nurse specialist
- B. Insurance claim used by noninstitutional providers and supplier to bill payers
- C. Coordination of Benefits
- D. Consolidated Omnibus Budget Reconciliation Act of 1985
Answer: B
NEW QUESTION # 203
What does AAMA stand for?
- A. Asian Association of Medical Assistants
- B. African Association of Medical Assistants
- C. American Association of Medical Assistants
- D. Australian Association of Medical Assistants
Answer: C
NEW QUESTION # 204
What does the acronym COB stand for in medical billing?
- A. Consolidated Omnibus Budget Reconciliation Act of 1985
- B. Certified Professional Coder
- C. Current Procedural Terminology
- D. Coordination of Benefits
Answer: D
NEW QUESTION # 205
......
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