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AAPC CPB Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Medical Billing Fundamentals | - Insurance types and payer structures - Healthcare reimbursement systems - Medical billing workflow and revenue cycle |
| Revenue Cycle Management | - Accounts receivable follow-up - Claims denial and rejection management - Payment posting and reconciliation |
| Insurance Processing and Payer Rules | - Medicare and Medicaid guidelines - Private insurance policies and contracts - Coordination of benefits (COB) |
| Coding and Claim Submission Basics | - ICD-10-CM, CPT, and HCPCS overview - Use of modifiers and coding compliance - Claims submission processes |
| Compliance and Regulations | - Billing compliance standards - HIPAA and patient privacy rules - Fraud and abuse prevention |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. Adjusted Claim is payment correction resulting in additional payment(s) to the provider.
A) TRUE
B) FALSE
2. Blue Cross Blue Shield (BCBS) is joint venture between Blue Cross and Blue Shield where the corporation shared one building and computer.
A) TRUE
B) FALSE
3. What does BS stand for?
A) Black Shield
B) Beneficiary Services
C) Blue Shield
D) Beneficiary Standards
4. DEERS
A) Durable Medical Equipment regional carriers
B) Durable Medical Equipment, Prosthetic and Orthotic Supplies
C) Durable Medical Equipment
D) Defense Enrollment Eligibility Reporting System
5. What does it mean by benign?
A) not cancerous
B) cancerous
Solutions:
| Question # 1 Answer: A | Question # 2 Answer: A | Question # 3 Answer: C | Question # 4 Answer: D | Question # 5 Answer: A |
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