Free Insurance, Billing & Coding (ICD/CPT) Practice Questions

1. Under coordination of benefits (COB), the birthday rule determines which parent's insurance is primary for a dependent child by:

• Assigning primary status to the parent whose birthday falls earlier in the calendar year, regardless of age
• Assigning primary status to the older parent based on their year of birth
• Assigning primary status to the father's insurance in all cases
• Splitting costs equally between both parents' plans without designating a primary

2. Which type of managed care plan requires members to select a primary care physician (PCP) and obtain referrals to see specialists?

• HMO (Health Maintenance Organization)
• PPO (Preferred Provider Organization)
• EPO (Exclusive Provider Organization)
• Indemnity plan

3. A medical office reviews its accounts receivable aging report and identifies several accounts at 120+ days. Which of the following is the most appropriate next step?

• Write off all accounts over 120 days as uncollectable
• Review each account individually, send a final collection letter, and consider referring delinquent accounts to a collection agency
• Call each patient and threaten to withhold future medical care until they pay
• Add interest charges retroactively to all accounts over 90 days

4. An Explanation of Benefits (EOB) is a document sent by the insurance company that:

• Explains what services were billed, what was paid, what was adjusted, and what the patient owes
• Authorizes the provider to perform a specific procedure
• Serves as proof that the patient has active insurance coverage
• Lists all CPT codes available for billing purposes

5. The MOST common reason for a medical insurance claim denial is:

• Errors in patient demographic information, missing or incorrect codes, or lack of prior authorization
• The patient being too old for the services provided
• The provider using the correct CPT and ICD-10 codes together
• Filing the claim within the timely filing deadline