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| Section | Weight | Objectives |
|---|---|---|
| Types of Insurance | 21% | - Managed care plans - Third-party liability - TRICARE/CHAMPUS, Workers' compensation - Commercial payers - Medicare, Medigap, Medicaid |
| Coding Concepts for Billers | 12% | - Medical necessity - ICD-10-CM, CPT®, HCPCS Level II - Code validation, modifiers |
| HIPAA and Compliance | 9% | - Fraud, abuse, False Claims Act - Privacy, security, transaction standards - Medical record retention - Compliance programs |
| Reimbursement and Collections | 14% | - Patient statements, collections - Payment posting, adjustments - Refunds, payment plans, write-offs - Accounts receivable management |
| Billing Regulations | 13% | - CMS-1500, UB-04 completion - Incident-to billing, global packages - ACOs, NCCI, LCDs, NCDs - Payer payment policies |
| Case Analysis | 17% | - Eligibility verification - End-to-end billing scenarios - Adjudication and resolution |
| Claims and Billing | 14% | - Electronic claims, clearinghouses - Denials, appeals, corrections - Timely filing rules - Claim submission, tracking, follow-up |
The Certified Professional Biller (CPB) CPB exam is a valuable credential that will assist you to advance your career. To pass the CPB exam is not an easy job. It always gives tough times to their candidates. The best CPB Exam Preparation strategy along with the Exam4Tests CPB exam practice test questions can help you to crack the AAPC CPB exam easily.
NEW QUESTION # 155
CAT stands for Computerized Axial Tomography.
Answer: A
NEW QUESTION # 156
Which document is mailed by the payer to the patient to illustrate the reimbrsement amount of a covered benefit?
Answer: D
NEW QUESTION # 157
The medical word root "hepat" or "hepat/o" refers to the:
Answer: B
NEW QUESTION # 158
CA refers to Cancer or Carcinoma.
Answer: A
NEW QUESTION # 159
Which scenario would most likely result in a claim denial for lack of medical necessity?
Answer: C
Explanation:
Medical necessity denials occur when the diagnosis does not justify the billed service.
NEW QUESTION # 160
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