Are flashcards effective for the CBCS exam?

Yes. Flashcards use active recall — retrieving an answer from memory — which research shows is one of the most effective study methods, especially in short, spaced sessions. They're ideal for the CBCS's heavy terminology in claim forms, payer rules, code sets, and reimbursement.

What topics do the CBCS flashcards cover?

All four content-outline domains: Revenue Cycle & Regulatory Compliance (HIPAA, fraud/abuse), Insurance Eligibility & Payers (plan types, COB, ABNs), Coding & Coding Guidelines (ICD-10-CM, CPT, HCPCS, modifiers), and Billing & Reimbursement (CMS-1500, UB-04, denials, appeals).

How should I study with these CBCS flashcards?

Lead with the heaviest domains — Billing & Reimbursement (33%) and Coding & Coding Guidelines (32%) — then Insurance (20%) and Revenue Cycle & Compliance (15%). Mix the modes: flip to learn, type to test recall, match for speed, and quiz to check yourself before a full practice test.

Are the CBCS flashcards free?

Yes — 100% free, all four study modes, no paywall.

Do these flashcards match the current CBCS exam blueprint?

Yes. The cards are organized to the NHA CBCS test plan — the four current domains and their weights — and cover the ICD-10-CM, CPT, and HCPCS Level II code sets the exam tests.

A claim with no errors or missing information that passes edits and can be processed and paid on the first submission.

The standard claim form used by physicians and other non-institutional (professional) providers; electronic equivalent is the 837P.

The institutional claim form (also called the CMS-1450) used by hospitals and facilities; electronic equivalent is the 837I.

Another name for the UB-04 institutional/hospital claim form.

A claim stopped before processing for a format or data error; it is corrected and resubmitted (it never entered the payer's system).

A claim the payer processed but refused to pay; it is corrected and formally appealed (not simply resubmitted).

Suspended (pended) claim

A claim held by the payer for review or additional information before adjudication.

Remittance advice (RA)

The statement a payer sends the provider explaining how each claim line was paid, adjusted, or denied.

Electronic remittance advice (ERA)

The electronic (HIPAA 835) version of a remittance advice sent to the provider.

Explanation of Benefits (EOB)

The statement a payer sends the patient showing how a claim was processed; it is not a bill.

Claim Adjustment Reason Code — a standardized code on a remittance advice explaining why a payment was adjusted.

Remittance Advice Remark Code — a supplemental code giving additional explanation alongside a CARC.

A formal request asking a payer to reconsider a denied or underpaid claim, with supporting documentation, within the timely-filing window.

The deadline by which a claim or appeal must be submitted; missing it usually forfeits payment.

The first level of the Medicare fee-for-service appeals process, performed by the claims contractor.

A service that receives electronic claims, validates and reformats them, and routes them to the correct payer.

The electronic claim transaction for professional (physician) services — the electronic CMS-1500.

The electronic claim transaction for institutional (facility) services — the electronic UB-04.

The field on the CMS-1500 where ICD-10-CM diagnosis codes are entered (up to 12).

The field where the CPT/HCPCS procedure code and any modifiers are entered.

Diagnosis pointer (24E)

The CMS-1500 block 24E entry that links each service line to its supporting diagnosis in block 21.

The field for the billing provider's name, address, and NPI.

A reimbursement model paying the provider for each individual service rendered.

A reimbursement model paying the provider a fixed amount per member per month regardless of services used.

Prospective payment system

A model paying a predetermined amount per case or service group, such as Medicare's DRGs and APCs.

Diagnosis-Related Group — the inpatient classification that pays a fixed amount per admission.

Ambulatory Payment Classification — the unit of payment for hospital outpatient services under OPPS.

The maximum a payer will pay for a covered service; the contracted or fee-schedule rate.

The contractual adjustment a provider must remove from the bill — the difference between the charge and the allowed amount.

Billing the patient for the difference between the provider's charge and the payer's allowed amount; often prohibited for in-network/Medicare.

The process of recording the services and items provided so they can be billed.

Software that checks a claim for errors and edits before submission to produce a clean claim.

Accounts receivable (A/R)

The money owed to a provider for services billed but not yet paid.

A report grouping outstanding A/R by how long it has been unpaid (e.g., 0-30, 31-60 days).

A daily record of charges, payments, and adjustments for a provider's patients.

An itemized form listing the services and diagnoses for an encounter, used to generate the claim.

Electronic Data Interchange — the electronic exchange of claim and remittance data between providers and payers.

A claim automatically forwarded from Medicare to a secondary payer (e.g., Medigap) after Medicare pays.

Coordination of benefits (claim)

Filing claims in the correct primary-then-secondary order when a patient has more than one plan.

A payer reducing a code to a lower level because documentation or the claim does not support the level billed.

The Fair Debt Collection Practices Act, which governs how patient balances may be collected.

A third party engaged to collect overdue patient balances under fair-debt rules.

The bill sent to a patient showing the balance due after insurance has paid.

The payer's process of reviewing a claim and deciding payment, adjustment, or denial.

The payment a provider receives from a payer or patient for services rendered.

Your FREE CBCS Flashcards 2026 – 200+ Cards

Realistic, CBCS exam-style flashcards across all 4 NHA domains — flip, match, type, and quiz yourself.

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CBCS Flashcards

Clean claim: A claim with no errors or missing information that passes edits and can be processed and paid on the first submission.
CMS-1500: The standard claim form used by physicians and other non-institutional (professional) providers; electronic equivalent is the 837P.
UB-04: The institutional claim form (also called the CMS-1450) used by hospitals and facilities; electronic equivalent is the 837I.
CMS-1450: Another name for the UB-04 institutional/hospital claim form.
Rejected claim: A claim stopped before processing for a format or data error; it is corrected and resubmitted (it never entered the payer's system).
Denied claim: A claim the payer processed but refused to pay; it is corrected and formally appealed (not simply resubmitted).
Suspended (pended) claim: A claim held by the payer for review or additional information before adjudication.
Remittance advice (RA): The statement a payer sends the provider explaining how each claim line was paid, adjusted, or denied.
Electronic remittance advice (ERA): The electronic (HIPAA 835) version of a remittance advice sent to the provider.
Explanation of Benefits (EOB): The statement a payer sends the patient showing how a claim was processed; it is not a bill.
CARC: Claim Adjustment Reason Code — a standardized code on a remittance advice explaining why a payment was adjusted.
RARC: Remittance Advice Remark Code — a supplemental code giving additional explanation alongside a CARC.
Appeal: A formal request asking a payer to reconsider a denied or underpaid claim, with supporting documentation, within the timely-filing window.
Timely filing: The deadline by which a claim or appeal must be submitted; missing it usually forfeits payment.
Redetermination: The first level of the Medicare fee-for-service appeals process, performed by the claims contractor.
Clearinghouse: A service that receives electronic claims, validates and reformats them, and routes them to the correct payer.
837P: The electronic claim transaction for professional (physician) services — the electronic CMS-1500.
837I: The electronic claim transaction for institutional (facility) services — the electronic UB-04.
Block 21 (CMS-1500): The field on the CMS-1500 where ICD-10-CM diagnosis codes are entered (up to 12).
Block 24D (CMS-1500): The field where the CPT/HCPCS procedure code and any modifiers are entered.
Diagnosis pointer (24E): The CMS-1500 block 24E entry that links each service line to its supporting diagnosis in block 21.
Block 33 (CMS-1500): The field for the billing provider's name, address, and NPI.
Fee-for-service: A reimbursement model paying the provider for each individual service rendered.
Capitation: A reimbursement model paying the provider a fixed amount per member per month regardless of services used.
Prospective payment system: A model paying a predetermined amount per case or service group, such as Medicare's DRGs and APCs.
DRG: Diagnosis-Related Group — the inpatient classification that pays a fixed amount per admission.
APC: Ambulatory Payment Classification — the unit of payment for hospital outpatient services under OPPS.
Allowed amount: The maximum a payer will pay for a covered service; the contracted or fee-schedule rate.
Write-off: The contractual adjustment a provider must remove from the bill — the difference between the charge and the allowed amount.
Balance billing: Billing the patient for the difference between the provider's charge and the payer's allowed amount; often prohibited for in-network/Medicare.
Charge capture: The process of recording the services and items provided so they can be billed.
Claim scrubber: Software that checks a claim for errors and edits before submission to produce a clean claim.
Accounts receivable (A/R): The money owed to a provider for services billed but not yet paid.
Aging report: A report grouping outstanding A/R by how long it has been unpaid (e.g., 0-30, 31-60 days).
Day sheet: A daily record of charges, payments, and adjustments for a provider's patients.
Superbill: An itemized form listing the services and diagnoses for an encounter, used to generate the claim.
EDI: Electronic Data Interchange — the electronic exchange of claim and remittance data between providers and payers.
Crossover claim: A claim automatically forwarded from Medicare to a secondary payer (e.g., Medigap) after Medicare pays.
Coordination of benefits (claim): Filing claims in the correct primary-then-secondary order when a patient has more than one plan.
Downcoding: A payer reducing a code to a lower level because documentation or the claim does not support the level billed.
FDCPA: The Fair Debt Collection Practices Act, which governs how patient balances may be collected.
Collection agency: A third party engaged to collect overdue patient balances under fair-debt rules.
Patient statement: The bill sent to a patient showing the balance due after insurance has paid.
Adjudication: The payer's process of reviewing a claim and deciding payment, adjustment, or denial.
Reimbursement: The payment a provider receives from a payer or patient for services rendered.
ICD-10-CM: The U.S. code set for reporting diagnoses and the reasons for an encounter, used in all settings.
CPT: Current Procedural Terminology — the AMA code set for physician and outpatient procedures and services.
HCPCS Level II: Codes for supplies, drugs, equipment, and services not covered by CPT.
Modifier: A two-character CPT/HCPCS addition giving detail about a service (bilateral, distinct, repeat); can change payment.
Medical necessity: The principle that a service must be reasonable and necessary; the diagnosis must support the procedure billed.
NCCI edits: National Correct Coding Initiative edits — automated checks that block improper code pairs and unbundling.
Unbundling: Reporting components of a service separately to get higher payment when one combined code applies — non-compliant.
Upcoding: Assigning a higher-level or more expensive code than the documentation supports — fraud.
Alphabetic Index: The part of the ICD-10-CM book where the coder first locates the main term for a condition.
Tabular List: The part of the ICD-10-CM book where the coder verifies the code and reads its instructional notes.
Excludes1 note: An ICD-10-CM convention meaning the two conditions are never coded together.
Excludes2 note: An ICD-10-CM convention meaning the condition is not included here but both may be coded if present.
Code first note: An ICD-10-CM instruction to sequence an underlying condition before the current code.
Use additional code: An ICD-10-CM instruction to add a secondary code to fully describe the condition.
Seventh character: An ICD-10-CM character required by some categories (e.g., to show the encounter type for an injury).
Placeholder X: The ICD-10-CM 'X' used to fill empty character positions so a required 7th character lands correctly.
NEC: Not Elsewhere Classifiable — used when a specific code does not exist for a documented condition.
NOS: Not Otherwise Specified — the equivalent of 'unspecified' when documentation lacks detail.
Laterality: ICD-10-CM detail specifying right, left, or bilateral for a paired body part.
E/M codes: Evaluation and Management CPT codes used to report office and other patient visits.
CPT Category I: The main CPT codes for widely used procedures and services (five digits).
CPT Category II: Optional CPT tracking codes for performance measurement.
CPT Category III: Temporary CPT codes for emerging technologies, services, and procedures.
Modifier 25: A significant, separately identifiable E/M service by the same provider on the same day as a procedure.
Modifier 50: Indicates a bilateral procedure (performed on both sides).
Modifier 59: A distinct procedural service, separate from another service performed the same day.
Bundling: Combining related services into a single code, as required by NCCI edits.
Principal diagnosis: The condition established after study to be chiefly responsible for an inpatient admission.
First-listed diagnosis: In outpatient coding, the main reason for the encounter, sequenced first.
Sequencing: Listing codes in the correct order — the principal/first-listed diagnosis first.
Encounter for examination: An ICD-10-CM code used when the reason for the visit is a routine exam, not a complaint.
Signs and symptoms: Codes assigned when no definitive diagnosis is documented for an outpatient encounter.
Diagnosis-procedure linkage: Connecting each procedure code to the diagnosis that justifies it on the claim.
Abstracting: Extracting the diagnoses, procedures, and data needed for coding from the health record.
Uncertain diagnosis (outpatient): 'Probable/suspected' conditions are NOT coded for outpatient encounters; code the documented signs/symptoms.
Chief complaint: The patient's stated reason for the visit, in their own words.
Coordination of benefits (COB): The rules that determine which plan pays first when a patient has more than one insurance plan.
Birthday rule: For a dependent child with two plans, the parent whose birthday falls earlier in the year is primary.
Primary insurance: The plan that pays first on a claim before any other coverage.
Secondary insurance: The plan that pays after the primary, often covering remaining balances.
HMO: Health Maintenance Organization — managed care requiring in-network providers and usually PCP referrals.
PPO: Preferred Provider Organization — managed care allowing out-of-network care without a referral at higher cost.
EPO: Exclusive Provider Organization — covers only in-network care but typically without referrals.
POS plan: Point-of-Service plan — combines HMO and PPO features; referrals for some out-of-network care.
Indemnity plan: A fee-for-service plan letting the patient see any provider, usually with higher out-of-pocket cost.
Medicare: The federal program for people 65+ and certain others: Parts A, B, C, and D.
Medicare Part A: Covers inpatient hospital, skilled nursing, and hospice care.
Medicare Part B: Covers physician services, outpatient care, and durable medical equipment.
Medicare Part C: Medicare Advantage — Parts A and B (and often D) delivered through private plans.
Medicare Part D: Covers prescription drugs through private plans.
Medigap: A private supplemental policy covering deductibles and coinsurance left by Medicare A and B.
Medicaid: The joint federal-state program for low-income individuals; generally the payer of last resort.
TRICARE: The federal health program for active-duty and retired military members and their families.
CHIP: The Children's Health Insurance Program for children in families above Medicaid limits.
Workers' compensation: Insurance covering work-related injuries and illness; a liability/third-party payer.
Assignment of Benefits (AOB): The patient's authorization for the payer to pay the provider directly.
Referral: A primary care physician's authorization for a patient to see a specialist (common in HMOs).
Precertification: Confirming that a service is covered by the payer before it is provided.
Preauthorization (prior auth): Payer approval required before a service or drug is provided.
Predetermination: An estimate of what the payer will cover for a planned service before it is done.
Eligibility verification: Confirming a patient's active coverage and benefits before a visit.
Copayment: A fixed dollar amount a patient pays for a covered service at the time of care.
Deductible: The amount a patient pays out of pocket each year before the plan begins to pay.
Coinsurance: The percentage of a covered service's cost the patient pays after the deductible.
Out-of-pocket maximum: The annual cap after which the plan pays 100% of covered services.
Stop-loss maximum: A limit on patient out-of-pocket spending after which the plan pays in full.
Premium: The amount paid (often monthly) to maintain insurance coverage.
Self-pay patient: A patient without insurance who is responsible for the full cost of care.
Advance Beneficiary Notice (ABN): CMS-R-131 notice telling a Medicare patient a service may be denied and they may owe for it.
Out-of-network: A provider not contracted with the patient's plan, usually paid at a lower rate or not at all.
Participating provider: A provider contracted with a payer, agreeing to its allowed amounts.
Insurance card: Documentation showing the member's plan, ID, group number, and payer contact for verification.
Beneficiary: The person covered by an insurance plan and entitled to its benefits.
Guarantor: The person responsible for paying a patient's bill (may differ from the patient).
Revenue cycle: The financial process tracking a patient encounter from scheduling through coding, billing, payment, and collections.
Front-end (revenue cycle): Pre-service tasks: scheduling, registration, eligibility verification, and authorizations.
Back-end (revenue cycle): Post-service tasks: claim submission, payment posting, denials, appeals, and collections.
HIPAA: The Health Insurance Portability and Accountability Act, protecting health information via Privacy and Security Rules.
PHI: Protected Health Information — individually identifiable health information protected under HIPAA.
Privacy Rule: The HIPAA rule governing the use and disclosure of protected health information.
Security Rule: The HIPAA rule protecting electronic protected health information (ePHI).
Minimum necessary: The HIPAA principle of using or disclosing only the least PHI needed for a purpose.
TPO: Treatment, Payment, and health-care Operations — disclosures permitted without separate authorization.
HITECH Act: The law that strengthened HIPAA enforcement and added breach-notification requirements.
Breach notification: The HITECH requirement to notify individuals and HHS after a breach of unsecured PHI.
Business associate: A vendor that handles PHI for a covered entity and must comply with HIPAA.
Fraud: Knowingly and intentionally submitting false claims for payment — e.g., billing for services not rendered.
Abuse: Improper billing practices causing unnecessary cost, without proven intent to deceive.
False Claims Act: The federal law imposing penalties for submitting false claims to the government.
Stark Law: The law prohibiting physician self-referral for certain services to entities they have a financial interest in.
Anti-Kickback Statute: The law prohibiting payment to induce referrals for services paid by federal health programs.
OIG: Office of Inspector General — the HHS office that investigates fraud, waste, and abuse.
Compliance plan: A formal program to prevent, detect, and correct fraud, abuse, and billing errors.
Provider Self-Disclosure Protocol: The OIG process letting providers voluntarily report and resolve potential fraud or abuse.
RAC: Recovery Audit Contractor — a CMS contractor that reviews claims to recover improper Medicare payments.
ZPIC: Zone Program Integrity Contractor — a CMS contractor that investigates potential Medicare fraud.
Informed consent: A patient's agreement to a treatment after being told its risks, benefits, and alternatives.
Implied consent: Consent inferred from a patient's actions or circumstances (e.g., an emergency).
Audit: A review of claims and documentation to verify accuracy and compliance.
Fair Debt Collection Practices Act: The federal law regulating how debts, including patient balances, may be collected.
Authorization (HIPAA): A patient's signed permission to use or disclose PHI for purposes beyond TPO.
Covered entity: A health plan, clearinghouse, or provider that transmits health information electronically and must follow HIPAA.
Indicators of fraud: Patterns such as duplicate billing, services not rendered, or upcoding that suggest fraud.
Notice of Privacy Practices: The document informing patients how their PHI may be used and disclosed.
Dirty claim: A claim with errors or missing information that cannot be processed and is rejected or returned.
Claim attachment: Supporting documentation (e.g., operative notes) submitted with a claim when required.
National Provider Identifier (NPI): A unique 10-digit number identifying a health-care provider on claims.
Tax Identification Number (TIN): The employer or provider identification number used for billing and tax reporting.
Place of service (POS) code: A code on the CMS-1500 indicating where a service was rendered (e.g., 11 = office).
Revenue code (UB-04): A code on the UB-04 identifying the type of service or department (e.g., room, pharmacy).
Condition code (UB-04): A UB-04 code describing a condition affecting payer processing of the claim.
Value code (UB-04): A UB-04 code reporting amounts or values necessary to process the institutional claim.
Occurrence code (UB-04): A UB-04 code reporting a significant event and date affecting the claim.
Type of bill (UB-04): A four-digit UB-04 field identifying the facility type and bill classification.
Posting payments: Recording payer and patient payments and adjustments against the patient's account.
Contractual adjustment: The amount a participating provider writes off per the payer contract.
Bad debt: A patient balance deemed uncollectible after collection efforts.
Refund: Money returned to a patient or payer after an overpayment is identified.
Overpayment: Payment exceeding the amount due; must be refunded or applied appropriately.
Reconsideration: The second level of the Medicare appeals process, performed by a Qualified Independent Contractor.
Administrative Law Judge (ALJ): The third level of the Medicare appeals process, a hearing before an ALJ.
Medicare Administrative Contractor (MAC): A private contractor that processes Medicare claims for a region.
Electronic claim: A claim submitted electronically (837) rather than on paper.
Paper claim: A claim submitted on a physical form (CMS-1500 or UB-04).
Batch (claims): A group of claims submitted together to a clearinghouse or payer.
Acknowledgment report: A clearinghouse or payer report confirming whether claims were accepted or rejected.
Days in A/R: A metric of how long, on average, it takes to collect payment after billing.
Collection ratio: The percentage of billed charges actually collected by the practice.
Capitation payment: A set per-member-per-month payment under a managed-care contract.
Adjustment: A change to a charge or payment, such as a write-off or correction.
Patient ledger: A record of all charges, payments, and adjustments for a single patient.
Claim status inquiry: An electronic request (276/277) asking a payer the status of a submitted claim.
Resubmission: Sending a corrected rejected claim back to the payer for processing.
Underpayment: A payer payment that is less than the contracted allowed amount.
ICD-10-CM convention: A rule (abbreviation, punctuation, symbol, or note) governing correct code assignment.
And (ICD-10-CM): In a code title, 'and' is interpreted as 'and/or'.
With (ICD-10-CM): In the index and tabular, 'with' means associated or due to, and links the conditions.
Default code: The ICD-10-CM code listed next to the main term, used when no further detail is documented.
Etiology/manifestation: A coding convention requiring the underlying cause to be sequenced before the manifestation.
Combination code: A single ICD-10-CM code reporting two diagnoses, or a diagnosis with a complication.
Add-on code (CPT): A CPT code reported with a primary procedure code, never alone.
Unlisted procedure code: A CPT code for a service with no specific code, requiring a report.
Global surgical package: A CPT concept bundling pre-, intra-, and post-operative care into the surgery code.
Bundled service: A service whose payment is included in another service and not billed separately.
Modifier 26: Professional component — the physician's interpretation portion of a service.
Modifier TC: Technical component — the equipment/facility portion of a service.
Modifier 51: Multiple procedures performed at the same session.
Modifier 76: Repeat procedure or service by the same physician.
Modifier GA: An ABN is on file for a service expected to be denied by Medicare.
HCPCS J-code: A HCPCS Level II code reporting injectable and other drugs.
HCPCS E-code: A HCPCS Level II code reporting durable medical equipment.
Z code (ICD-10-CM): A code for encounters with circumstances other than disease or injury (e.g., screening).
External cause code: An ICD-10-CM code describing how an injury occurred; never sequenced first.
Acute vs chronic: When both are documented and indexed separately, code both, sequencing acute first.
Coding from the index alone: An error — the index must be confirmed in the Tabular List before coding.
Specificity: Using the most precise code the documentation supports (e.g., full laterality and detail).
Comorbidity: A coexisting condition that affects patient care and may be coded as secondary.
Encoder: Software that helps a coder find and assign correct codes.
Local Coverage Determination (LCD): A MAC's policy on whether a service is covered in its region.
National Coverage Determination (NCD): A nationwide Medicare policy on whether and when a service is covered.
Medically Unlikely Edit (MUE): An NCCI edit capping the units of a service allowed per patient per day.
Coding compliance: Assigning only codes supported by documentation, following official guidelines.
Group number: The identifier on an insurance card linking the member to an employer or plan group.
Subscriber: The primary policyholder under whom dependents are covered.
Dependent: A spouse or child covered under the subscriber's plan.
Effective date: The date a patient's insurance coverage begins.
Termination date: The date a patient's insurance coverage ends.
Open enrollment: The period when individuals may enroll in or change insurance plans.
Formulary: A payer's list of covered prescription drugs.
Capitated plan: A plan paying providers a fixed amount per member regardless of services used.
Gatekeeper: The primary care physician in an HMO who must authorize specialist care.
Allowable charge: The maximum amount a plan considers payable for a covered service.
Nonparticipating provider: A provider not contracted with a payer; may balance-bill where allowed.
Medicaid as last resort: Medicaid pays only after all other available coverage has paid.
Dual eligible: A patient covered by both Medicare and Medicaid.
Tertiary insurance: A third plan that pays after primary and secondary coverage.
Dependent rule: COB rules determining how a child's coverage is ordered between parents' plans.
Verification of benefits: Confirming what services a plan covers and the patient's cost share.
Prior authorization number: The approval number a payer issues that must appear on the claim.
Medicare Summary Notice (MSN): The quarterly statement Medicare sends beneficiaries listing claims and payments.
CHAMPVA: A federal health program for families of veterans with service-connected disabilities.
Catastrophic plan: A high-deductible plan covering essential benefits after a large out-of-pocket amount.
Middle (revenue cycle): The service phase: clinical documentation and assigning diagnosis and procedure codes.
Patient registration: Collecting demographic and insurance information at the start of an encounter.
Demographic information: Patient identity data (name, DOB, address) collected at registration.
Encounter form: A document capturing the services and diagnoses for a visit (similar to a superbill).
Designated record set: The records a covered entity uses to make decisions about an individual under HIPAA.
De-identified information: Health data with identifiers removed so it is no longer PHI.
Disclosure: Releasing PHI outside the entity that holds it.
Use (of PHI): Sharing or handling PHI within the entity that holds it.
Right to access: A patient's HIPAA right to inspect and obtain a copy of their health information.
Accounting of disclosures: A patient's HIPAA right to a list of certain disclosures of their PHI.
Civil monetary penalty: A fine imposed for HIPAA or False Claims Act violations.
Qui tam: A False Claims Act provision letting a whistleblower sue on the government's behalf.
Internal audit: A self-review of coding and billing accuracy within the organization.
External audit: A review of claims by an outside payer or contractor (e.g., a RAC).
Corporate Integrity Agreement: An OIG agreement a provider follows after resolving fraud allegations.
Code of conduct: The ethical standards staff follow as part of a compliance program.
Sentinel event: A serious, unexpected occurrence that triggers review and possible reporting.
Patient confidentiality: The duty to protect a patient's health information from unauthorized disclosure.

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By Career EmployerUpdated Sep 12, 2026

200+ free CBCS flashcards — 4 ways to study

CBCS Flashcard of the DayNew daily

The classic card. Do you know this one?

Click Study Flashcards above to open the flashcard hub — hundreds of CBCS cards you can flip, match, type, or quiz yourself on. Every card is drawn from the four official NHA knowledge domains, so you study exactly what the exam tests.^[2] Pair them with our free practice test and study guide.

CBCS Flashcard Study Modes

Flip mode lets you read a front, recall the answer, and turn the card over at your own pace. Match times you as you pair terms with definitions. Type hides the term and asks you to spell it from the definition, so a front like UB-04 has to come back exactly. Quiz turns the same 245 cards into multiple-choice questions for a quick check.

Free CBCS flashcards from Career Employer — active recall for the NHA Certified Billing & Coding Specialist exam

Why Flashcards Work for the CBCS

Billing & Reimbursement is the heaviest domain on the CBCS at 33%, and it is the largest block in the deck with 75 cards. The fronts drill payment classification and claim mechanics side by side: DRG and APC cover how facilities and outpatient services get grouped for payment, while UB-04 and the electronic 837I test whether you know which form carries which claim. Denial-side vocabulary such as CARC and RARC shows up here too, along with EDI as the transmission layer underneath it all.

Coding & Coding Guidelines is close behind at 32% with 64 cards. These fronts cover code set names, convention shorthand, and the integrity language that surrounds them. You get CPT and ICD-10-CM as anchors, the abbreviations NEC and NOS that trip people up when they appear in an index or tabular entry, and practical terms like Modifier and Encoder. Compliance-flavored coding words such as Upcoding and Bundling also sit in this group, since the exam expects you to name the practice, not just describe it.

Insurance Eligibility & Other Payer Requirements accounts for 20% and holds 58 cards. Managed care plan types dominate, with HMO, PPO, and EPO needing clean separation, and government or supplemental programs filling out the rest through fronts like CHIP, TRICARE, CHAMPVA, and Medigap. Cost-sharing vocabulary such as Premium rounds out the set so you can talk about what a patient owes before a claim ever goes out.

Revenue Cycle & Regulatory Compliance is 15% of the exam and 48 cards here. Expect privacy and oversight terms: PHI and TPO on the HIPAA side, plus the audit and enforcement bodies behind OIG, RAC, and ZPIC. The pairing of Fraud and Abuse gets its own treatment, because the distinction between intent and improper practice is a common exam target.

The CBCS is dense with terminology — revenue-cycle phases, HIPAA rules, payer and plan types, the CMS-1500 and UB-04 forms, ICD-10-CM/CPT/HCPCS code sets, and denial and appeal workflows.^[3] Spaced flashcards are the most efficient way to keep it all fresh. Used alongside our practice test and study guide, they turn review time into measurable progress.

CBCS Flashcards by Domain

The cards are organized by the four official NHA domains. Drill the highest-weighted ones first — Billing and Coding together are nearly two-thirds of the exam:^[2]

CBCS flashcards by knowledge domain and weight
Domain	Exam weight
Billing & Reimbursement	33%
Coding & Coding Guidelines	32%
Insurance Eligibility & Other Payer Requirements	20%
Revenue Cycle & Regulatory Compliance	15%

How to Get the Most Out of These Flashcards

Start with Billing & Reimbursement. At 33% and 75 cards, it is both the heaviest domain and the biggest block, so early passes there pay off across the most exam questions.
Type-drill the abbreviations. Fronts like CARC and RARC, or 837P against 837I, are easy to recognize and hard to produce, which is exactly what Type mode exposes.
Use Match for plan types. Timed pairing suits the Insurance Eligibility & Other Payer Requirements fronts such as HMO, PPO, and EPO, where speed of recognition matters more than long explanation.
Move to the practice test after two clean Quiz passes. When the cards stop surprising you, switch to full-length questions and use the study guide to repair whatever the results expose.
Work one domain per session. With 245 cards, rotating through Billing & Reimbursement, Coding & Coding Guidelines, then the smaller two keeps every label in rotation without long gaps.

CBCS Flashcards FAQ

Hundreds of free CBCS flashcards, organized across all four NHA knowledge domains — Revenue Cycle & Regulatory Compliance, Insurance Eligibility & Other Payer Requirements, Coding & Coding Guidelines, and Billing & Reimbursement. They're free with no account required.

References

1.National Healthcareer Association. “Certified Billing and Coding Specialist (CBCS).” nhanow.com. ↑
2.National Healthcareer Association. “CBCS Test Plan for the CBCS Exam (2020 Practice Analysis).” nhanow.com. ↑
3.Centers for Medicare & Medicaid Services. “CMS-1500 Paper Claim and Institutional Billing.” cms.gov. ↑

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