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AAPC - American Academy of Professional Coders

Certified Professional Biller

The CPB certification by AAPC validates expertise in medical billing and coding. A Certified Professional Biller (CPB) is a credential awarded to medical billing professionals who have demonstrated knowledge in maintaining all aspects of the revenue cycle, particularly patient and payer billing and collections.

Prüfungscode

CPB

Dauer

120 min

Questions

100

Certified Professional Biller
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Assesses knowledge of managed care, commercial payers, Medicare, Medigap, Medicaid, Blue Cross/Blue Shield, TRICARE/CHAMPUS, workers’ compensation, and third-party payers.
Covers ACOs, NCCI, LCDs, NCDs, incident-to billing, global packages, unbundling, CMS-1500 and UB-04 forms, and payer payment policies.
Tests HIPAA privacy, billing compliance, medical record retention, financial policies, and fraud and abuse.
Addresses RBRVs, payer and patient refunds, provider credentialing, accounts receivable, debt collection, payment plans, preauthorizations, claim editing, and remittance advice.
Tests appeals, denials, claims tracking/follow-up, timely filing, demographics, superbills, record retention, balance billing, electronic claims, clean claims, and billing audits.

Domäne 5

Claims and Billing

Tests appeals, denials, claims tracking/follow-up, timely filing, demographics, superbills, record retention, balance billing, electronic claims, clean claims, and billing audits.

Domäne 6

Coding

Assesses knowledge of CPT®, ICD-10-CM, and HCPCS Level II codes and modifiers.

Domäne 7

Case Analysis

Provides source documents and policies for examinees to apply in coding scenarios.

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