Medical billing encompasses many parts, from claims and denials to payer policies and reimbursement. Earning the Certified Professional Biller (CPB) certification can prove you understand how all those pieces work together across the billing cycle. In this guide, we’ll explain what you should know about the CPB certification exam, what it includes, and how you can prepare for it.
What Is the CPB Certification Exam?
The Certified Professional Biller (CPB) certification exam assesses your medical billing knowledge. It’s administered by the American Academy of Professional Coders (AAPC). If you pass the exam, you earn the Certified Professional Biller credential, which can help prove your expertise in claims, denials, and the complete billing cycle.
Who Can Take the CPB Certification Exam?
It’s available to those starting their careers in medical billing or those looking to advance in the field. To be eligible for the exam, you should meet the CPB certification requirements, which include having a strong knowledge of medical terminology, anatomy, and pathophysiology. You should also be familiar with these areas:
- Payer policies
- Compliance rules
- Healthcare regulations
- CPT codes
- HCPCS Level II procedure and supply codes
- ICD-10-CM diagnosis codes
If you don’t have prior healthcare experience or training, it’s a good idea to complete a postsecondary medical billing program before taking the exam. Many programs integrate CPB exam preparation into the curriculum. At American Career College, the Medical Billing and Coding Specialist program helps prepare students to take the CPB exam, and it can be completed fully online in less than 9 months.
What’s on the CPB Certification Exam?
The CPB exam tests your knowledge of different medical billing areas. It includes 135 questions in these subjects:
Types of Insurance
This part of the exam includes 29 questions about how different insurance plans work. It tests your knowledge of managed care plans, private insurance, government programs, and other types of payers.
Billing Regulations
These 17 questions focus on medical billing regulations. Questions in this area cover accountable care organizations, local coverage determinations, billing forms, and payer payment policies.
HIPAA and Compliance
This area includes 7 questions on your knowledge of healthcare compliance. The questions focus on HIPAA privacy, billing compliance, financial policies, and record retention.
Reimbursement and Collections
This section of the exam includes 19 questions about payment and collections. Content in this area includes payer and patient refunds, provider credentialing, collections, payment plans, preauthorizations, and remittance advice.
Claims and Billing
In this part of the exam, you’re tested on your knowledge of the claims process. The 19 questions focus on appeals, denials, claims tracking, record retention, electronic claim submissions, and auditing practices.
Coding
The coding part of the CPB exam includes 10 questions. These cover your knowledge of code sets, including CPT, ICD-10-CM, and HCPCS Level II codes.
Case Analysis
This section makes up the largest part of the exam with 34 questions. Using provided source documents and policies, you’ll answer some situational questions about claim forms, payment policies, preauthorizations, appeals, and coverage determinations.
How to Study for the CPB Exam
Before taking the CPB certification exam, you should study the content so you feel better prepared. Follow these steps to prepare for the test:
Know the Exam Format
Before exam day, take some time to familiarize yourself with the format. The CPB exam includes 135 multiple-choice questions, and you must answer at least 95 correctly to earn a 70% minimum passing score.
You’ll have 4 hours to take the exam, which means you have a little under 2 minutes for each question, according to the AAPC. It’s in your best interest to answer all the questions, so use your time wisely. Also, it’s an open-book exam, so you can have these approved materials with you:
- American Medical Association (AMA) CPT Professional Edition
- ICD-10-CM, any publisher
- HCPCS Level II, any publisher
Plan a Study Schedule
Create a study schedule you can realistically stick to as you prepare for the exam. Decide how much time you’ll need to prepare for each content area. Find a place where you can study without distractions, whether it’s your home, the library, or a local coffee shop.
Create a Study Guide
A study guide can be helpful for guiding your exam preparation. The AAPC offers study guides you can use, or you can create your own. Divide the guide into the topics covered in the exam and list your notes in each area. If you’re a visual learner, create flashcards or other visual aids to help you study.
Take a Practice Exam
If possible, take a practice exam before the big day. Try to simulate the exam setting and set a time limit for completing the practice test. Practice some calming strategies you can use during the actual exam, like deep breathing or focus exercises.
Once you’re done, look over the questions you missed and identify areas to keep studying before exam day.
Study With Others
Consider joining a study group to help with your preparation. A study group can allow you to ask questions, share study materials, and get additional help with topics you may find difficult. If you’ve completed a medical billing program, check with other classmates who may also be preparing for the CPB exam and ask if they’d be interested in studying with you.
What Happens After the CPB Exam?
After the exam, you will receive your results from the AAPC. You should know your score about 7 to 10 business days after the date of your exam. If you earn a 70% or higher, you pass the exam and will receive your certificate in the mail.
If you don’t pass the first time, don’t worry. You’re allowed to retake the test when you feel ready.
Prepare for the CPB Exam With Support From ACC
The CPB certification exam tests your knowledge of different areas, including insurance, billing regulations, coding, compliance, and reimbursement. It may seem like a lot, but some thoughtful preparation ahead of time can help you go into the exam with confidence.
If you’re looking for a structured training program before you take the test, ACC’s Medical Billing and Coding Specialist program can be a good place to start. It’s available 100% online, so you can study wherever it’s most convenient for you.
The program combines online coursework with a 130-hour online practicum designed to help you put your coursework into practice. Through hands-on learning activities, you can build experience with coding procedures, insurance guidelines, and claims processes in a real-world setting. In less than 9 months, you can graduate with a diploma and be ready to sit for the CPB certification exam.
Ready to learn more? Reach out today for more information!
