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AAPC CPB Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Topic 1: Compliance and Regulations | - Fraud and abuse prevention - Billing compliance standards - HIPAA and patient privacy rules |
| Topic 2: Revenue Cycle Management | - Accounts receivable follow-up - Claims denial and rejection management - Payment posting and reconciliation |
| Topic 3: Medical Billing Fundamentals | - Insurance types and payer structures - Healthcare reimbursement systems - Medical billing workflow and revenue cycle |
| Topic 4: Insurance Processing and Payer Rules | - Private insurance policies and contracts - Coordination of benefits (COB) - Medicare and Medicaid guidelines |
| Topic 5: Coding and Claim Submission Basics | - Claims submission processes - Use of modifiers and coding compliance - ICD-10-CM, CPT, and HCPCS overview |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. Which is the universal claim form used by physicians offices?
A) Explanation of Benefits
B) Health Insurance Claim
C) Hold Harmless Clause
D) Centers of Medicare and Medicaid Services150 (CMS1500)
2. HPSA stands for Health Personnel Shortage Area.
A) TRUE
B) FALSE
3. What is the main purpose of an audit in medical billing?
A) Increase workload
B) Ensure billing accuracy and compliance
C) Speed up reimbursements
D) Punish billers
4. The medical word root "hemat" or "hemat/o" refers to:
A) liver
B) below, under
C) half
D) blood
5. What does AHA stand for?
A) American Hospital Association
B) American Hostel Association
C) American Hospitality Association
D) American Healthcare Association
Solutions:
| Question # 1 Answer: D | Question # 2 Answer: A | Question # 3 Answer: B | Question # 4 Answer: D | Question # 5 Answer: A |
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