AAPCs Certified Professional Biller Credential

As a medical billing instructor, I am frequently asked about the new CPB credential from AAPC. I think this new credential is great, and I feel students just out of a good medical billing course do have a chance of passing the test.

The CPB test measures the billers ability to understand and handle all aspects of the revenue process.

These abilities including the following:

  • Familiarity with different types of insurance plans
  • Ability to apply payer policies and local and national coverage determinations.
  • Understanding basic CPT, ICD-9, and HCPCS medical coding guidelines and conventions.
  • Understanding the medical billing claim cycle.
  • Understanding claim and patient follow-up.
  • Understanding resubmitting claims and denial resolutionThe exam itself has 200 multi-choice questions and is timed at 5 hours and 40 minutes. You do get one free retake with the fee. The exams tests for the following knowledge:
  • Managed care, Medigap, Medicare, Medicaid, Blue Cross/Blue Shield, Tricare/CHAMPUS, Worker’s Comp, Third party payers.
  • National Correct Coding Initiative, Global Packages, Unbundling, Completion of the CMS1500 and UB04 forms (in detail)
  • HIPPA, Billing Compliance, Medical Record Retention, Office Financial Policies, Fraud and Abuse issues.
  • RBVS, refunds, Accounts Receivable, Collections procedures, Payment Plans, Preauthorizations, Remittance Advice, Filing Guidelines.
  • Appeals, denials, Resubmissions. Follow Up, Balance Billing issues, Telephone Etiquette, Clean Claims, Superbill forms, Auditing.
  • Basic CPT, ICD-9, and HCPCS coding.

AAPCs Certified Professional Biller Credential

There will then be 50 questions left on the exam of case studies where you will be given documents and policies and asked to apply those policies regarding CMS-1500, appeal letters, payment policies, remittance advice, accounts receivable reports, and claims follow up.

There is no doubt that the exam is intensive and good exam preparation is essential. If you have taken a quality medical billing course using a very good gold-standard textbook that also included case studies, etc., then you are well on your way to passing the exam.  I highly recommend to my students to purchase the study guide and practice exam from AAPC. It’s also a nice idea to have other practice exams to really assess your readiness for this exam.  Then, schedule your exam, and see how you do. If you pass, it’s GREAT news. If not, you now know what you need to work on to pass on your second attempt. Go over your textbook, study guide, and practice tests again. Review your weak areas. I suggest taking at least a month before retaking to give yourself time to really study again what you need to in a relaxed manner. Sometimes answers to questions may be very similar and answering very quickly may lead you to a wrong choice. So, read questions very well. Ask yourself- “What is this question testing me on?”  Certification exams can be nerve wracking for sure. However, if you decide in the beginning that “no matter what” you WILL pass the exam, then you will continue to test, study, test, until you’ve got your credential.

I do feel that a medical billing credential is important for your career because it signifies professionalism and documents through a well-known entity such as AAPC that you know your stuff :).  Every learner is different. Some people may be able to study for the exam a month and pass without any problem. Other people will need to study longer. Some may not pass simply because they were moving to slowly through the questions and ran out of time. Then, it’s an issue of doing more practice tests and learning to move faster.  One exam testing technique that may be helpful is to go through the test twice. On your first go through, answer all easy questions that you know very well or will take little time to figure out. Then, go back and do your harder questions. Remember to allow enough time for your 50 case studies. I’d TRY to allow at least an hour for them, but 2 hours would be even better. The more “facts” you know off the top of your head like HIPAA guidelines, the major blocks on the CMS-1500 form, etc. the faster you can move through those types of questions.  You can bring in your CPT, ICD, and HCPCS books into the exam. Have those books tabbed with notes. Remember these books in the beginning pages have a LOT of information in them. KNOW where that information is located with tabs, highlight what is important, and make notes to where you do not have to go on a major “hunt” to find what you need.

The number one thing you need to pass the CPB exam is to make a firm choice in your own mind that NOTHING will stop you. Prepare well. OVER prepare. If you pass the first time, wonderful news. If you don’t, you have NOT failed anything. You simply now have more knowledge on what you need to do for your next attempt.  A CPB is a CPB is a CPB. What I mean by that is that it does not matter if you pass on your first or 21st exam attempt (not that any of you would need to take it 21 times. I’m exaggerating a bit here.). Most of my students who have sat for the exam have passed on their second attempt. The number one problem they had on the first attempt was not allowing enough time on the case studies and feeling a bit confused regarding them.  This is why PRACTICE EXAMS are very important. Since this is a NEW credential there may not be tons of available practice exams. I know CCO has plans to offer some of these. I know AAPC has 3 practice exams. For some people that is plenty used in conjunction with having taken a solid medical billing course, and using the AAPC CPB study guide. However, “slower” test takers may need more practice with more practice exams.

By: Dawn Moreno, PhD, CPC, CBCS, CMAA, MTC. Lives in the beautiful Southwest United States and has been an instructor for medical coding/billing for the past 7 years.  Interested in quality medical billing training?

Get More Details about AAPCs Certified Professional Biller

Certified Medical Biller – Professional Associations for Medical Billers

AAPC – Online Medical Billing Course

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