AAPC Certified Professional Biller (CPB) : CPB

  • Exam Code: CPB
  • Exam Name: Certified Professional Biller (CPB)
  • Q & A: 245 Questions and Answers

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AAPC CPB Exam Syllabus Topics:

SectionWeightObjectives
Claims and Billing14%- Timely filing rules
- Denials, appeals, corrections
- Claim submission, tracking, follow-up
- Electronic claims, clearinghouses
Reimbursement and Collections14%- Payment posting, adjustments
- Accounts receivable management
- Refunds, payment plans, write-offs
- Patient statements, collections
Billing Regulations13%- Payer payment policies
- Incident-to billing, global packages
- CMS-1500, UB-04 completion
- ACOs, NCCI, LCDs, NCDs
Types of Insurance21%- TRICARE/CHAMPUS, Workers' compensation
- Third-party liability
- Managed care plans
- Commercial payers
- Medicare, Medigap, Medicaid
HIPAA and Compliance9%- Fraud, abuse, False Claims Act
- Privacy, security, transaction standards
- Compliance programs
- Medical record retention
Case Analysis17%- Eligibility verification
- Adjudication and resolution
- End-to-end billing scenarios
Coding Concepts for Billers12%- Code validation, modifiers
- Medical necessity
- ICD-10-CM, CPT®, HCPCS Level II

AAPC Certified Professional Biller (CPB) Sample Questions:

Question 1

Blue Shield (BS) __________

A. began as a resolution passed by the house of Delegates at an American Medical Association meetings in 1939; incorporates a concept of voluntary health insurance that encourages physicians to corporate with prepaid health plans.
B. began as a resolution passed by the house of Delegates at an American Medical Association meetings in 1940; incorporates a concept of voluntary health insurance that encourages physicians to corporate with prepaid health plans.
C. began as a resolution passed by the house of Delegates at an American Medical Association meetings in 1941; incorporates a concept of voluntary health insurance that encourages physicians to corporate with prepaid health plans.
D. began as a resolution passed by the house of Delegates at an American Medical Association meetings in 1938; incorporates a concept of voluntary health insurance that encourages physicians to corporate with prepaid health plans.


Question 2

CLIA

A. Competitive Medical Plan
B. Clinical Laboratory Improvement Act
C. Centers of Medicare and Medicaid Services
D. UB04 Claim used by institutional and other selected providers to bill payers


Question 3

American Academy of Processional Coders (AAPC) is professional association established to provide a national certification and credentialing process, to support the national and local membership by providing educational products and opportunities to network, and to increase and promote national recognition and awareness of professional coding.

A. TRUE
B. FALSE


Question 4

GCPI stands for Geographic Cost Practice Index.

A. TRUE
B. FALSE


Question 5

EPO

A. External Quality Review Organization
B. Exclusive provider organization
C. Electronic Remittance Advice
D. Early and Periodic screening, diagnostic, and treatment


Solutions:

Question 1
Answer: D
Question 2
Answer: B
Question 3
Answer: A
Question 4
Answer: A
Question 5
Answer: B

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