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CMAA · 10% of the exam

Billing and Revenue Cycle practice questions

10 free Billing and Revenue Cycle questions for the Certified Medical Administrative Assistant (CMAA) exam, each with the correct answer and an explanation for every option.

Start the questionsFree 10-question CMAA quiz

What this domain covers

The revenue cycle: coding basics, claims, payments and following up on what is owed.

Exam weight
10%
On a real exam
≈ 14 questions
In our bank
65 questions

Topics that come up most

  • CPT, ICD-10-CM and HCPCS basics
  • Superbills and charge entry
  • Claim submission and clean claims
  • Explanation of benefits and denials
  • Patient statements and collections

How to study it

Follow one claim from charge to payment, including what happens on a denial; that sequence covers most of the domain.

Sample Billing and Revenue Cycle questions

Try each one before opening the answer. Original questions written to the official exam objectives.

  1. Question 1

    What are CPT modifiers used for?

    • AAdding detail about a service without changing its code
    • BReplacing diagnosis codes
    • CListing patient demographics such as address and phone number on the claim
    • DCalculating copays
    Show answer and explanation

    Answer: A) Adding detail about a service without changing its code

    • ACorrect. For example, a bilateral procedure.
    • BIncorrect. They modify procedure codes.
    • CIncorrect. They modify procedure codes.
    • DIncorrect. They modify procedure codes.

  2. Question 2

    When an insurance payment is received, the assistant should:

    • AReturn it to the payer
    • BHold it for a month
    • CPost it to the account
    • DKeep it in petty cash
    Show answer and explanation

    Answer: C) Post it to the account

    • AIncorrect. Only if paid in error.
    • BIncorrect. Post promptly.
    • CCorrect. Payments are posted and balances updated.
    • DIncorrect. Deposit it properly.

  3. Question 3

    What is charge capture?

    • ACollecting a patient's credit card for future use without consent
    • BRecording all billable services provided
    • CLocating patients who owe money
    • DAdjusting contractual write-offs
    Show answer and explanation

    Answer: B) Recording all billable services provided

    • AIncorrect. That isn't charge capture.
    • BCorrect. Missed charges mean lost revenue.
    • CIncorrect. That's skip tracing.
    • DIncorrect. That's posting.

  4. Question 4

    A patient who receives monthly Social Security retirement benefits asks how her Medicare Part B premium is usually paid. Which answer is accurate?

    • AIt is deducted from her monthly Social Security benefit payment
    • BIt is collected by the office as a copayment at each Part B visit
    • CIt is paid by her physician and recovered through claim reimbursement
    • DIt is withheld from her paycheck as part of the Medicare payroll tax
    Show answer and explanation

    Answer: A) It is deducted from her monthly Social Security benefit payment

    For beneficiaries who receive Social Security benefits, the Part B premium is usually deducted from the monthly benefit. Others are billed directly, and some get premium help through Medicaid or Medicare Savings Programs.

    • ACorrect. For people who receive Social Security (or Railroad Retirement or OPM) benefits, the Part B premium is taken out of the monthly benefit. People who don't receive these benefits are billed directly, and some low-income people get help from Medicaid or a Medicare Savings Program.
    • BIncorrect. A copayment or coinsurance is cost-sharing for a specific service. The premium is a separate monthly charge for having coverage and is not collected at the office.
    • CIncorrect. Providers don't pay beneficiaries' premiums. The premium is the beneficiary's obligation, though a state Medicaid program or Medicare Savings Program may pay it for eligible people.
    • DIncorrect. Medicare payroll taxes mainly fund Part A, which is why most people get Part A without a premium. The Part B premium is a separate monthly premium, not a payroll tax.

  5. Question 5

    While posting an electronic remittance advice (ERA), a medical administrative assistant sees a claim line paid at less than the billed amount, with a claim adjustment reason code (CARC) attached. What does the CARC tell the assistant?

    • AThe overall reason for the financial adjustment, such as a denial or reduction
    • BWhich party is financially responsible for the unpaid balance, such as CO or PR
    • CSupplemental detail or informational alerts that cannot be expressed by other codes
    • DProvider-level adjustments not tied to one claim, such as interest or recoupments
    Show answer and explanation

    Answer: A) The overall reason for the financial adjustment, such as a denial or reduction

    CARCs give the overall reason a payer adjusted a claim or line, such as a denial or reduced payment. Group codes assign financial responsibility, RARCs add detail, and PLB codes cover provider-level adjustments.

    • ACorrect. CMS says CARCs give the overall explanation for financial adjustments to a claim or service line, such as denials, reductions or increases in payment.
    • BIncorrect. Assigning financial responsibility is the job of group codes. For example, CO (contractual obligation) puts the balance on the provider, and PR (patient responsibility) puts it on the patient.
    • CIncorrect. That describes remittance advice remark codes (RARCs). RARCs add detail to a CARC or pass along informational messages, including 'Alert' remarks.
    • DIncorrect. Adjustments at the provider level, such as interest payments or overpayment deductions, are reported with provider level balance (PLB) reason codes, not CARCs.

  6. Question 6

    A patient asks the practice to keep a credit card on file to pay any balance left after insurance processes each claim. What should the office have before it charges the card?

    • AA signed card-on-file authorization from the patient stating when and how charges may be made
    • BA verbal OK from the patient at check-in, noted by the front desk in the scheduling system
    • CThe insurer's explanation of benefits showing the patient's share, which itself permits the charge
    • DA signed assignment of benefits form, which lets the office collect the balance from any payment source
    Show answer and explanation

    Answer: A) A signed card-on-file authorization from the patient stating when and how charges may be made

    Before charging a card on file, the office needs the patient's signed authorization stating when and how charges may be made, and the patient should keep a copy. EOBs and assignment-of-benefits forms do not give permission to charge the card.

    • ACorrect. The patient (the cardholder) must agree to future charges in a signed or similarly authenticated document. The document should set out the terms, such as when charges happen and any limits, and the patient should get a copy.
    • BIncorrect. A passing verbal OK leaves no record of the agreed terms and gives the patient no copy. That puts the office at risk of disputes and chargebacks.
    • CIncorrect. The EOB shows how much the patient owes. It does not give the office permission to charge the patient's card. Only the patient can do that.
    • DIncorrect. An assignment of benefits tells the insurer to pay the provider directly. It does not authorize charges to the patient's personal credit card.

  7. Question 7

    In medical billing, what is upcoding?

    • ACoding a service exactly as it was documented in the record
    • BBilling a higher-level service than was provided
    • CUpdating the code book each year
    • DUsing a modifier correctly
    Show answer and explanation

    Answer: B) Billing a higher-level service than was provided

    • AIncorrect. That's correct coding.
    • BCorrect. It's a form of fraud.
    • CIncorrect. That's maintenance.
    • DIncorrect. That's correct coding.

  8. Question 8

    A claim was denied for a wrong member ID number. The best action is to:

    • AFile a formal lawsuit
    • BBill the patient in full
    • CWrite off the claim
    • DFix the ID and resubmit
    Show answer and explanation

    Answer: D) Fix the ID and resubmit

    • AIncorrect. This is unnecessary.
    • BIncorrect. Fix the claim first.
    • CIncorrect. It can be corrected.
    • DCorrect. Correct the data and resubmit the claim.

  9. Question 9

    An accounts receivable aging report groups unpaid balances by:

    • AProvider specialty
    • BPatient age
    • CDays overdue
    • DDiagnosis code
    Show answer and explanation

    Answer: C) Days overdue

    • AIncorrect. This is not the grouping.
    • BIncorrect. Age refers to the balance.
    • CCorrect. It sorts balances by age, such as 30, 60 and 90 days.
    • DIncorrect. This is not the grouping.

  10. Question 10

    A patient has two health plans. The primary plan has processed the claim, and the office is now preparing the claim for the secondary plan. What should usually go with the secondary claim?

    • AA copy of the patient's signed financial policy and photo ID
    • BThe complete medical record for the date of service
    • CThe primary payer's EOB or remittance advice showing what it allowed, paid or denied
    • DThe receipt showing the copayment the patient paid at check-in
    Show answer and explanation

    Answer: C) The primary payer's EOB or remittance advice showing what it allowed, paid or denied

    Under coordination of benefits, the primary plan pays first. The secondary claim goes with the primary payer's EOB or remittance advice so the secondary payer can see what was allowed, paid or denied.

    • AIncorrect. These documents are kept on file at the office. They don't tell the secondary payer what the primary paid.
    • BIncorrect. Records are sent only when a payer asks for them. Coordinating benefits depends on the primary payer's payment information.
    • CCorrect. The secondary payer uses the primary's EOB or remittance advice to coordinate benefits and work out what it owes.
    • DIncorrect. A copay receipt shows only what the patient paid. It doesn't show how the primary plan processed the claim.

Billing and Revenue Cycle: FAQs

How much of the CMAA exam is Billing and Revenue Cycle?

Billing and Revenue Cycle is 10% of the CMAA exam by the official exam guide's weighting, which on a 135-question form works out to roughly 14 questions. The real exam's exact split varies by form.

What does the Billing and Revenue Cycle domain cover?

The revenue cycle: coding basics, claims, payments and following up on what is owed.

How should I study Billing and Revenue Cycle for CMAA?

Follow one claim from charge to payment, including what happens on a denial; that sequence covers most of the domain.

Where can I practise more Billing and Revenue Cycle questions?

This page has 10 free Billing and Revenue Cycle questions with answers. The ExamWize CMAA question bank has 65 questions in this domain. Every practice exam result breaks your score down by domain, and Review Mode re-drills the questions you missed.

Other CMAA topics

Also: 15 free questions across all topics, the CMAA cheat sheet and the study guide.

Get Billing and Revenue Cycle exam-ready

The full CMAA bank has 65 Billing and Revenue Cycle questions. Timed practice exams match the real exam's length and domain weights, every result shows your score per domain, and Review Mode re-drills the questions you missed.

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Not affiliated with NHA; questions are original, written from the official exam outline, and never copied from the real exam.