If a claim is underpaid by the primary insurer, the secondary insurer may be billed if:

"Breaking the glass" in an electronic health record system is:

Accessing a patient’s record for personal curiosity is considered:

The term “remittance advice” (ERA) refers to:

A Notice of Privacy Practices (NPP) must be provided to patients:

A duplicate claim occurs when:

A claim denial due to "timely filing" indicates that:

An Excludes1 note in the coding manual indicates that:

The primary purpose of the HIPAA Privacy Rule is to:

Payment posting involves:

Coinsurance is defined as:

Medigap policies are designed to:

“Remittance processing” involves:

Modifier 25 is used when:

Medicare Part B is used to reimburse:

Medicaid eligibility is generally based on:

An Excludes2 note means:

If a provider’s charge is $600 and the allowed amount is $450, the contractual discount is:

A PPO plan allows patients to:

Which insurance program is most closely associated with retirees?

A replacement claim is indicated on the CMS‑1500 form by:

Which department is typically responsible for following up on unpaid claims?

“Denial management” involves:

The term "clean claim" refers to:

A copayment (copay) is:

The UB‑04 form is used for:

The CMS‑1500 form is used primarily for billing:

Billing modifiers should be used only when:

A “superbill” is:

Prior authorization is required when:

An Exclusive Provider Organization (EPO) plan generally:

HIPAA applies to:

Accessing a patient’s record without a work‑related reason is considered:

The term “contractual discount” refers to:

If a breach of unsecured protected health information affects 500 or more individuals, the provider must:

ICD‑10‑CM codes are used for:

Which of the following is a private insurance carrier?

Which of the following is NOT typically part of revenue cycle management?

Which modifier is commonly used to indicate a repeat procedure by the same provider on the same day?

The HIPAA Security Rule specifically protects:

A provider’s “charge master” is:

The purpose of the appeals process is to:

Correct coding and billing are dependent on:

“Bundled payment” means that:

Medicaid primarily serves:

A consumer‑directed health plan (CDHP) is characterized by:

For a billing error related to coding, the first corrective step is to:

Which of the following is a step in the billing process?

When an injection is performed separately from an E/M service on the same day, the appropriate modifier for the E/M service is:

The timely filing limit for Medicare claims is generally:

A global surgical package includes:

HIPAA stands for:

Modifier 57 indicates that:

Patient insurance eligibility is typically verified:

An Advance Beneficiary Notice (ABN) is used to:

An essential component of the billing process is:

The False Claims Act applies primarily to claims submitted to:

Patients under HIPAA have the right to:

Which form is primarily used to submit claims for physician professional services?

Which CPT code is commonly used for a typical office visit of moderate complexity?

“Unbundling” refers to:

Modifier 50 is used for:

Medicare Part A primarily covers:

Coordination of Benefits (COB) is used to:

On the CMS‑1500 form, the provider’s National Provider Identifier (NPI) is reported in:

Capitation is best described as:

Which of the following is a common reason for claim denials?

TRICARE provides health coverage for:

When using a combination code, the code must:

"De‑identified" data under HIPAA means that:

Coordination of Benefits (COB) is necessary when:

A claim resubmitted due to a denial is known as a:

A combination code is defined as one that:

A Business Associate Agreement (BAA) is required when:

The “explanation of benefits” (EOB) is:

In an HMO plan, patients are typically required to:

The "minimum necessary" standard requires that:

“Charge capture” refers to:

The National Correct Coding Initiative (NCCI) is intended to:

In claims processing, an “adjustment” refers to:

When a service is provided within a global period, the related services are:

When coding an etiology and manifestation pair, the correct sequence is to:

An “aging report” in billing is used to:

An overpayment by an insurer should be:

HCPCS Level II codes are used primarily for:

Upon discovering a breach of PHI, a covered entity must:

Which insurance plan is designed specifically for active‐duty military personnel and their families?

A patient’s financial responsibility is determined by:

A clearinghouse’s role in billing is to:

A HIPAA breach can result in:

Which of the following is NOT considered Protected Health Information (PHI) under HIPAA?

Which of the following is prohibited under proper billing regulations?

For a patient with a high deductible health plan, it is expected that:

A claim submitted after the timely filing limit will most likely be:

Under HIPAA, a patient has the right to request:

CPT codes are maintained by:

The purpose of modifiers in billing is to:

Self‑funded health plans are most commonly offered by:

Modifier 59 is used to:

“Allowable amount” is defined as:

The HIPAA Enforcement Rule is designed to:

When a patient requests a copy of their medical records, the provider must comply within:

Covered entities under HIPAA must implement:

A claim scrubber is used to:

A correct use of a modifier requires: