CPB™ Exam Prep — Complete Course
Certification · Advanced · 5 lessons
0% complete
CPB™ blueprint & the billing workflow end to end
14 min read
The AAPC CPB™ exam is 100 multiple-choice questions in 4 hours with a 70% passing score, covering insurance types, billing regulations, HIPAA compliance, reimbursement, claim forms, payment posting, accounts receivable and the collections process. Unlike the CPC®, the emphasis is on the money path rather than code assignment.
- ✓Revenue cycle order: scheduling → registration/eligibility → prior auth → charge capture → coding → claim scrubbing → submission → remittance → patient billing → AR follow-up → denial/appeal → zero balance.
- ✓Clean claim rate, days in AR, first-pass resolution rate and denial rate are the KPIs a biller is judged on.
- ✓Professional services bill on the CMS-1500 (837P); facility services on the UB-04 (837I).
- ✓Timely filing limits differ by payer — Medicare is 12 months from date of service; commercial plans are often 90–180 days.
- ✓Coordination of benefits determines primary vs. secondary; the birthday rule applies for dependent children with two commercial plans.
Flashcards
Tap a card to flip
Case studies
Apply the guidelines to real documentation
Eligibility failure
A claim denies CO-27 'expenses incurred after coverage terminated.' Registration recorded the plan the patient presented at check-in, but no eligibility verification was run.
Best corrective action for the account and the process?
Knowledge check
3 questions
1. Which claim form is used for hospital facility charges?
2. Two commercial plans cover a child. Which plan is primary under the birthday rule?
3. Medicare's timely filing limit for most claims is: