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AAPC CPB Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Topic 1: Medical Billing Fundamentals | - Insurance types and payer structures - Healthcare reimbursement systems - Medical billing workflow and revenue cycle |
| Topic 2: Revenue Cycle Management | - Accounts receivable follow-up - Claims denial and rejection management - Payment posting and reconciliation |
| Topic 3: Insurance Processing and Payer Rules | - Medicare and Medicaid guidelines - Private insurance policies and contracts - Coordination of benefits (COB) |
| Topic 4: Compliance and Regulations | - Billing compliance standards - HIPAA and patient privacy rules - Fraud and abuse prevention |
| Topic 5: Coding and Claim Submission Basics | - Claims submission processes - ICD-10-CM, CPT, and HCPCS overview - Use of modifiers and coding compliance |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. What document is used to transfer patient financial responsibility after insurance adjudication?
A) Prior Authorization
B) CMS-1500
C) UB-04
D) Patient Statement
2. Case manager submits written confirmation, authorizing treatment, to provider.
A) FALSE
B) TRUE
3. What does CCS stand for?
A) Certified Coding Standards
B) Certified Coding Specialist
C) Certified Coding Services
4. BCAC stands for Beneficiary Counseling and Assistance Coordinator.
A) FALSE
B) TRUE
5. What should be done if an insurance company incorrectly denies a covered service?
A) File an appeal with supporting documentation
B) Write off the charge
C) Resubmit the same claim without changes
D) Bill the patient immediately
Solutions:
| Question # 1 Answer: D | Question # 2 Answer: B | Question # 3 Answer: B | Question # 4 Answer: B | Question # 5 Answer: A |
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