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| Section | Weight | Objectives |
|---|---|---|
| Coding Concepts for Billers | 12% | - Medical necessity - ICD-10-CM, CPT®, HCPCS Level II - Code validation, modifiers |
| HIPAA and Compliance | 9% | - Privacy, security, transaction standards - Compliance programs - Medical record retention - Fraud, abuse, False Claims Act |
| Claims and Billing | 14% | - Timely filing rules - Electronic claims, clearinghouses - Denials, appeals, corrections - Claim submission, tracking, follow-up |
| Reimbursement and Collections | 14% | - Accounts receivable management - Refunds, payment plans, write-offs - Payment posting, adjustments - Patient statements, collections |
| Case Analysis | 17% | - Adjudication and resolution - Eligibility verification - End-to-end billing scenarios |
| Types of Insurance | 21% | - Medicare, Medigap, Medicaid - Managed care plans - Third-party liability - TRICARE/CHAMPUS, Workers' compensation - Commercial payers |
| Billing Regulations | 13% | - CMS-1500, UB-04 completion - Incident-to billing, global packages - ACOs, NCCI, LCDs, NCDs - Payer payment policies |
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The AAPC CPB certification exam is one of the top-rated career booster certifications in the market. This Certified Professional Biller (CPB) (CPB) certification offers a great opportunity for AAPC aspirants to validate their skills and knowledge. By doing this they can gain several personal and professional benefits. These CPB Certification benefits help them not only prove their expertise but also enable them to gain multiple career opportunities in the highly competitive market.
NEW QUESTION # 242
What does HA stand for?
Answer: B
NEW QUESTION # 243
What should be done if an insurance company incorrectly denies a covered service?
Answer: A
Explanation:
Appeals require corrected information and documentation to support payment.
NEW QUESTION # 244
What does ADA stand for?
Answer: B
NEW QUESTION # 245
The medical prefix "ab-" means:
Answer: D
NEW QUESTION # 246
The medical word root "hemat" or "hemat/o" refers to:
Answer: C
NEW QUESTION # 247
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