Certified Professional Biller (CPB)
The CPB (Certified Professional Biller) certificate prepares medical billers with the skills to maintain all aspects of the sales cycle. Without expertise in medical billing and the nuances of payment requirements, reimbursement for healthcare providers can be impacted.
Confirm your expertise
Through rigorous testing and experience, mutual funds have demonstrated that they know how to file claims in accordance with government regulations and private indemnity guidelines. You track claims status, resolve claim denials, file claims, record payments and adjustments, and manage collections. The CPB Medical Billing Eligibility Certificate is critical to the financial success of the professional healthcare claim process.
The CPB exam
- 200 multiple choice questions (supervised)
- 5 hours and 40 minutes to complete the exam
- 1 free repetition that can be used within one year of the first attempt
- one free repeat
- Open codebook (manuals)
The CPB exam includes the following:
- Types of insurance
- 44 questions
- Treatment protocol
- Commercial Payer
- Medicare
- Medigap
- Medicaid
- Blue cross / blue shield
- TRICARE / CHAMPUS
- Workers compensation
- Third party paying (car, civil liability, etc.)
Accounting rules
- 25 questions
- Responsible care organizations (ACO)
- National Correct Coding Initiative (NCCI)
- Local coverage determination (LCD)
- National coverage determination (NCD)
- Billing incident
- Global packages
- Unbundling
- CMS-1500 Completion
- Completion of UB-04
- Pay payment instructions
HIPAA and compliance
- 10 questions
- HIPAA Privacy
- Billing compliance
- Retention of medical records
- Financial policy
- Fraud and abuse
Refund and collection
- 28 questions
- RBRVS
- Patient payment and reimbursement
- Supplier IDs
- conditions
- Fair debt
- Patient testimony
- Patient discharge
- Professional courtesy
- Collection agencies
- The collections
- bankruptcy
- Payment plans
- Pre-authorizations
- Complaints handling tools
- Transfer notice
Billing
- 28 questions
- Calls
- The rejects
- Monitoring and tracking of losses
- Timely submission
- Demography
- Superbill / Meeting Forms
- Keep records
- Payment of the balance
- Courtesy phone
- Electronic application
- Own claims
- Review the invoicing process
Coding
- 15 questions
- CPT®
- ICD-10-CM
- HCPCS Level II
- Modifiers
Case analysis
In this section of the exam, the source documents are made available to the candidate for review. Candidates are given various guidelines and must be able to apply them.
The documents provided include:
- 50 questions
- CMS 1500 application forms
- Transfer information
- Payment policy
- Local coverage regulation (LCD)
- National coverage determinations (NCD)
- Letter of appeal
- Pre-authorizations
- Accounts Receivable Reports
- Complaints follow-up reports
Learn more about the CPB exam
- CPB Study Guide
- CPB Preparation Course (online)
- Practice exam
- CPB exam
CPB : Online Medical Billing Course Save up to 62%
The final online medical billing rate was intended to provide the most up-to-date information on the health insurance industry and the various reimbursement methods for the correct filing of claims. Success prepares students to take the CPB exam and work in a medical billing department in a doctor’s office, clinic, facility, other healthcare facility, or as a claims assessor for insurers.
CPB Study Guide
The CPB Study Guide reviews each section of the CPB exam in detail, providing practical examples, sample questions, and testing techniques. If you have billing experience or have successfully completed medical billing training (like the courses listed above), this study guide makes exam preparation simple.
CPB Online Practice Examinations
These 50-question online practice exams are recommended for anyone taking the CPB ™ exam. These practice exams mimic the content and difficulty of the actual exam and allow you to familiarize yourself with the format and time constraints of the actual test. The three practice exams, which correspond to the exam length of 150 questions, can be purchased separately or as a complete package.
Approved Manuals for Use During Examination
Required References:
- CPT® Books (AMA standard or professional edition ONLY). No other publisher is allowed.
- Your choice of ICD-10-CM.
- Your choice of HCPCS Level II.
