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AAPC CPB Exam Syllabus Topics:

Section	Weight	Objectives
Topic 1: Case Analysis	17%	- End-to-end billing scenarios - Adjudication and resolution - Eligibility verification
Topic 2: Types of Insurance	21%	- Commercial payers - Managed care plans - Third-party liability - TRICARE/CHAMPUS, Workers' compensation - Medicare, Medigap, Medicaid
Topic 3: HIPAA and Compliance	9%	- Fraud, abuse, False Claims Act - Privacy, security, transaction standards - Compliance programs - Medical record retention
Topic 4: Claims and Billing	14%	- Claim submission, tracking, follow-up - Timely filing rules - Denials, appeals, corrections - Electronic claims, clearinghouses
Topic 5: Reimbursement and Collections	14%	- Refunds, payment plans, write-offs - Patient statements, collections - Accounts receivable management - Payment posting, adjustments
Topic 6: Coding Concepts for Billers	12%	- Code validation, modifiers - Medical necessity - ICD-10-CM, CPT®, HCPCS Level II
Topic 7: Billing Regulations	13%	- CMS-1500, UB-04 completion - Payer payment policies - Incident-to billing, global packages - ACOs, NCCI, LCDs, NCDs

AAPC Certified Professional Biller (CPB) Sample Questions:

1. What does AHFS stand for?

A) American Healthcare Formulary Service
B) American Hospital Formulary Service
C) American Hospital Formulary Standards
D) American Healthcare Formulary Standards

2. arthr

A) two
B) condition
C) joint

3. BCBSA stands for Blue Cross Blue Shield Association.

A) TRUE
B) FALSE

4. What does it mean by galact and lact?

A) water
B) milk
C) alcohol

5. Accept Assignment

A) The amount owed to a business for services or goods provided.
B) Shows the status (by date) of outstanding claims from each payer, as well as payments due from patients.
C) Provider accepts as payment in full whatever is paid on the claim by the payer (except for any copayment and or coinsurance amounts.)
D) Assists providers in the collection of appropriate reimbursement for services rendered; include functions such as insurance verification/eligibility and preauthorization of services.

Solutions:

Question # 1
Answer: B

Question # 2
Answer: C

Question # 3
Answer: A

Question # 4
Answer: B

Question # 5
Answer: C