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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Reimbursement and Collections | 14% | - Refunds, payment plans, write-offs - Patient statements, collections - Payment posting, adjustments - Accounts receivable management |
| Topic 2: Types of Insurance | 21% | - Third-party liability - Medicare, Medigap, Medicaid - Commercial payers - TRICARE/CHAMPUS, Workers' compensation - Managed care plans |
| Topic 3: Billing Regulations | 13% | - CMS-1500, UB-04 completion - Incident-to billing, global packages - Payer payment policies - ACOs, NCCI, LCDs, NCDs |
| Topic 4: HIPAA and Compliance | 9% | - Compliance programs - Privacy, security, transaction standards - Medical record retention - Fraud, abuse, False Claims Act |
| Topic 5: Coding Concepts for Billers | 12% | - Code validation, modifiers - ICD-10-CM, CPTยฎ, HCPCS Level II - Medical necessity |
| Topic 6: Case Analysis | 17% | - Eligibility verification - Adjudication and resolution - End-to-end billing scenarios |
| Topic 7: Claims and Billing | 14% | - Claim submission, tracking, follow-up - Timely filing rules - Electronic claims, clearinghouses - Denials, appeals, corrections |
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NEW QUESTION # 176
When is an Advance Beneficiary Notice (ABN) required?
Answer: B
Explanation:
An ABN informs Medicare patients that they may be financially responsible if coverage is denied.
NEW QUESTION # 177
EFT
Answer: B
NEW QUESTION # 178
Case law is also common law; based on a court decision that establishes a precedent.
Answer: A
NEW QUESTION # 179
What does it mean by cyan?
Answer: D
NEW QUESTION # 180
What does ADA stand for?
Answer: B
NEW QUESTION # 181
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P.S. Free 2026 AAPC CPB dumps are available on Google Drive shared by DumpsMaterials: https://drive.google.com/open?id=1a3A8a444rp9MbwOZ0iQwfWXor9NUMPuN