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AAPC CPB Exam Syllabus Topics:

Section	Weight	Objectives
HIPAA and Compliance	9%	- Medical record retention - Fraud, abuse, False Claims Act - Compliance programs - Privacy, security, transaction standards
Types of Insurance	21%	- Commercial payers - TRICARE/CHAMPUS, Workers' compensation - Managed care plans - Medicare, Medigap, Medicaid - Third-party liability
Claims and Billing	14%	- Denials, appeals, corrections - Timely filing rules - Electronic claims, clearinghouses - Claim submission, tracking, follow-up
Billing Regulations	13%	- CMS-1500, UB-04 completion - Payer payment policies - Incident-to billing, global packages - ACOs, NCCI, LCDs, NCDs
Reimbursement and Collections	14%	- Accounts receivable management - Refunds, payment plans, write-offs - Payment posting, adjustments - Patient statements, collections
Coding Concepts for Billers	12%	- ICD-10-CM, CPT®, HCPCS Level II - Code validation, modifiers - Medical necessity
Case Analysis	17%	- Eligibility verification - End-to-end billing scenarios - Adjudication and resolution

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Error-Free AAPC CPB Exam Questions PDF Format

The AAPC CPB certification from AAPC is a sought-after recognition of ExamCost skills and knowledge. With this Certified Professional Biller (CPB) certification, professionals can enhance their careers, boost earnings, and showcase their expertise in a competitive job market. The benefits of passing the CPB Exam are numerous, but preparing for the exam is not a simple feat.

AAPC Certified Professional Biller (CPB) Sample Questions (Q208-Q213):

NEW QUESTION # 208
EOB

A. Explanation of Benefits
B. Early and Periodic screening, diagnostic, and treatment
C. Exclusive provider organization
D. External Quality Review Organization

Answer: A

NEW QUESTION # 209
Capitation

A. Provider accepts preestablished payments for providing healthcare services to enrollees over a period of time (usually one quarter)
B. Provider accepts preestablished payments for providing healthcare services to enrollees over a period of time (usually one year)
C. Provider accepts preestablished payments for providing healthcare services to enrollees over a period of time (usually 6 months)
D. Provider accepts preestablished payments for providing healthcare services to enrollees over a period of time (usually one month)

Answer: B

NEW QUESTION # 210
CPT

A. CHAMPUS Reform Initiative
B. Customized SubCapitation Plan
C. Computed Tomography
D. Current Procedural Terminology

Answer: D

NEW QUESTION # 211
Which factor determines the correct payer sequence in coordination of benefits (COB)?

A. Birthday rule
B. Patient preference
C. Length of employment
D. Provider type

Answer: A

Explanation:
The birthday rule is used for dependents to determine primary coverage.

NEW QUESTION # 212
Preauthorization is an authorization that must be received from a payer before treatment by a specialist will be covered.

A. TRUE
B. FALSE

Answer: A

NEW QUESTION # 213
......

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