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AAPC Certified Professional Biller (CPB) Sample Questions:

1. CMS

A) Centers of Medicare and Medicaid Services
B) Clinical nurse specialist
C) UB04 Claim used by institutional and other selected providers to bill payers
D) Insurance claim used by noninstitutional providers and supplier to bill payers

2. What does AHFS stand for?

A) American Healthcare Formulary Standards
B) American Hospital Formulary Service
C) American Healthcare Formulary Service
D) American Hospital Formulary Standards

3. HIPPS stands for Health Insurance Prospective Payment System (code set).

A) FALSE
B) TRUE

4. Allowable Charge

A) Adopted by Medicare in 2008 to reimburse hospitals for inpatient care provided to Medicare beneficiaries; expanded original DRG system (based on intensity of resources) to add two subclasses to each DRG that adjusts Medicare inpatient hospital reimbursement rates for of mortality (ROM) (likelihood of dying); each subclass, in turn, is subdivided into four areas: (1) minor, (2) moderate, (3) major, (4) extreme.
B) See limiting charge; maximum fee a physician may charge.
C) The Maximum amount the payer will reimburse for each procedure or service, according to the patients policy.
D) DRG system adapted for use by thirdparty payers to reimburse hospitals for inpatient care provided to nonMedicare beneficiaries (e.g. Blue Cross Blue Shield, commercial health plans, TRICARE); DRG assignment is based on intensity of resources.

5. HEDIS stands for Health Plan Employer Data and Information Set.

A) FALSE
B) TRUE

Solutions: