PMBA | Test Taker Handbook | Your Comprehensive Guide to Exam Success

Test Taker and Certification Handbook

Dear Test Taker,

Congratulations on your decision to earn a credential Professional Medical Billers Association LLC, USA. You have taken the first step to becoming recognized for your experience and expertise in Medical Billing.

Medical Billing is a comprehensive work that requires the skills of medical coding, CMS-1500 claim form, HIPAA Complaince, Insurance regulations, Appeals etc.

Professional Medical Billers Association LLC, USA, with a mission to efficient and effective medical billers, developed various Tools, Guides, Training and Certification.

Organizations that employ professionals certified through PMBA can expect the highest levels of competency. The ability to adhere to industry standards and regulations is demonstrated through attaining credentials. CPMB^® – Certified Professional Medical Billers are leaders in healthcare revenue cycle management thereby displaying a commitment to the industry, their colleagues, and patients.

Certifications offered by Professional Medical Billers Association LLC, USA are achieved through successful completion of an eligibility application and examination process. A credential offered by Professional Medical Billers Association LLC, USA symbolizes a combination of education, experience, and, computer-based onsite certification exams.

When you successfully pass a certification exam, you’re considered certified. To maintain the certification over subsequent years, you have to study for and take interim exams that test your knowledge of Medical Coding and Billing.

Maintaining your certification requires a yearly maintenance fee of $69 which includes your Working Membership cost of $69.

Certification Handbook describes the benefits of certification and a Test Taker Handbook describes the application criteria, steps, and deadlines.

Please email for any questions about these materials.

Thank you for your interest, and we wish you success.

Sincerely,

Testing Support Team

Professional Medical Billers Association LLC, USA

How to use this Handbook

This guide summarizes key aspects of Professional Medical Billers Association LLC, USA credential programs and is intended to help you understand policies and procedures and the steps to earning the credentials.

This handbook includes information about

Eligibility qualification
How to apply for certification
How to schedule examination
Points to remember while writing examination
What to expect after completing the examination
Maintaining the certification

We suggest Test Takers to go through this handbook and make a note on important points mentioned about certification and examination. In case any of your query or question is unanswered in this handbook or you need any help for your certification and examination, please e-mail or contact us as mentioned below.

Contact Information : support@pmbausa.com

Certification : certification@pmbausa.com

Training : training@pmbausa.com

Examination : exams@pmbausa.com

About Professional Medical Billers Association LLC, USA

Professional Medical Billers Association LLC, USA, based out of Colorado., is the one of the fastest growing organization to provide credential program in field of Medical Billing. Established by industry experts with vast knowledge and expertise in the field of medical coding and billing, Professional Medical Billers Association LLC, USA strives to provide cost-effective credential program for Medical Billing.

Certifications Offered

CPMB^®- Certified Professional Medical Biller

Purpose of the CPMB^® Certification

The purpose of the CPMB^® credentials is to

Establish a recognized standard of knowledge and competency for the medical coding and billing professionals as per ICD-10 coding environment
Formally recognize those who meet the qualifying standards of Professional Medical Billers Association LLC, USA
Provide a tool to identify skilled, knowledgeable Medical Billers
Support the benefits of professional continuing education and development
Assess the level of knowledge demonstrated by professionals in a valid and reliable manner
Encourage professional growth in the field

Statement of Non-Discrimination

Professional Medical Billers Association LLC, USA endorses the principles of equal opportunity. Eligibility criteria for examination and certification to become a Certificate Holder from Professional Medical Billers Association LLC, USA are applied equally to all individuals regardless of age, race, religion, gender, national origin, veteran status, or disability.

How the Professional Medical Billers Association LLC, USA Credential Program was developed

The Professional Medical Billers Association LLC, USA Academy credential programs are developed by a team of physicians and experienced healthcare revenue cycle managements professionals to evaluate knowledge of a Test Taker’s knowledge and application of Medical Billing, keeping in view the competencies that professional should possess.

The eligibility requirements, study materials, and examination for the certifications are developed by professionals based on a thorough study of the knowledge required by professionals for Medical Billing Profession. A panel of expert advisors reviewed the results of the study and identified the scope of certification examination, thus ensuring that the content of study guide and questions for certificate examinations reflect the proficiency of passing Test Taker.

The examination question pool will be continually updated to reflect updated medical billing policies and procedures. CPMB^® certification examinations have been designed to meet examination industry standards for validity and reliability.

Benefit of CPMB^® Certification

Certification is a mean for establishing that a certified professional possesses the knowledge and skill necessary for implementation and able to perform assigned task effectively and efficiently. It marks a professional as an exceptional individual in his/her field.

A certification can improve an individual’s overall performance, increase confidence, and broaden market opportunities. The process of achieving and maintaining the certification also helps ensure that you are continually improving and refining your skill sets.

Certification awarded by PMBA, USA is a representation of competency, knowledge, and proficiency in Medical Billing. PMBA encourages certification because it is the most effective way to help employees and employers to demonstrate their continual commitment towards compliance. Our certification process is a part of system developed by PMBA to create and sustain an industry-recognized standard for Medical Billing Profession,Certifications can help employers match job requirements with a Test Taker’s qualifications. Quite simply, the certifications you hold can be the difference between you and a lesser-qualified Test Taker. Certificates give students an overall job and confidence boost, by bringing more responsibilities, better career mobility and recognized expertise.

The fact that one holds a certification also tells employers that they have hired a knowledgeable and productive individual. It demonstrates that one honors commitment and follow-through, two traits that employers recognize and appreciate. It shows that one possesses the determination and skills to complete a challenging program, revealing highly prized traits of self-discipline and problem solving. By completing a certification program, one can acquire new knowledge and skills, enabling one to get up-to-speed rapidly when change occurs.

Studies have shown that certified professionals are more productive in their work. Because of their knowledge and skills, access to special resources, and problem-solving abilities, certified employees are able to implement solutions more quickly and with fewer problems than their noncertified counterparts. And surveys show that certified professionals, in general, are paid more than their non-certified counterparts.

Perhaps the best aspect of certification programs is that they allow individuals to control their own career. Whether one’s current employer supports staff certification or not, individuals can develop themselves and take control of their knowledge, skills, and future by becoming certified in their field.

Benefits of certification for employers include assurance of knowledge, increased productivity, enhanced professionalism, less training time needed to bring employees come up the curve, and prepare them for bigger role in future.

Examination Development

The examination is developed to assess the competencies of individual appearing for it. Examination is constructed through the coordinated efforts of the subject matter experts and examination developers who provided information on the measurement characteristics of the examination. In order to maintain the relevancy of the examination, question bank development is an ongoing process.

Certification Overview

CPMB^® – Certified Professional Medical Biller

Exam Fees – $199 (Includes PMBA One year membership)

Exam Pattern:

500 multiple choice questions

One mark per question No negative marking for wrong answer

45 Days from date of Login Open code book (ICD-10 coding manuals)

70% passing percentage One free retake allowed

Topic	Marks
US Healthcare	50
HIPAA Compliance and Regulations	50
Medical Terminology	50
Medical Coding (ICD-10-CM, CPT, HCPCS)	100
CMS-1500 Claim form	50
Insurance carriers	50
Appeals	25
Case Studies	100
Denial Management	50
Information Technology	25
EOBs, RA etc	50
Ethics	10

Examination Fees

The fee CPMB^® is $199. The detailed Study guide is available freely for the working members.

Examination fees Includes the following

CPMB^® Exam- One free retake
CPMB^® Study Guide
PMBA one year membership
Guide to start your home-based billing business
Guide to Becoming a Health Claims Assistance Professional
Medical Billing Starter Kit
CPMB^® Mock Exam

Certification Value Pack

Includes the following

If you have enrolled for Certification Value Pack, then you do not need pay any fees towards your CPMB Exam.

Eligibility Requirements

Must have a high school diploma but an associate’s degree is highly recommended

Test Takers are required to have a current Working Membership with ICA

Study materials allowed for examination

No reference or study material may be brought in to the examination room. Coding manuals with tabs, handwritten notations or comments are allowed.

How to prepare for the Examination

PMBA offers the following suggestions for preparing for its CPMB^® Certification Exam

Test Takers must go through CPMB^® Study Guide provided by PMBA USA, and also the Understanding health insurance by Michelle Green

Test Takers should plan their studies based on the examination outline. For examples, for areas you have good understanding, you may need to do a quick review, whereas areas in which you are less familiar, you may need to devote more time and pay more attention to prepare for the examination

When planning your studying, you should also keep in mind the number of questions from each topic, in case you are not familiar with the content area that will include a significant portion of the examination questions, you probably should spend additional time studying those topics.

There are many resources available to Test Taker to prepare for the examination, it is advisable for Test Takers to go through them to increase and improve their knowledge.

CPMB^® Official Study Guide

The Study Guide by PMBA is concise yet detailed guide to preparing oneself for the certification. This list is intended for use as a study aid only. The PMBA does not intend the study guide to imply endorsement of these specific references, nor are the test questions necessarily taken from this source.

Certification Process

To obtain the certification, Test Taker needs to successfully pass the computer-based examination. Certification examination can be scheduled any time during the year. If a Test Taker does not pass the examination during the first attempt, they have opportunity to one retake at and appear for the examination again.

Certification Maintenance

When you successfully pass a certification exam, you’re considered certified. To maintain the certification over subsequent years, you have to study for and take interim exams that test your knowledge of updated Medical Billing, ICD-10 codes and guidelines. Maintaining your certification requires a yearly maintenance fee of $69 which includes your Working Membership cost of $69.

Scoring Information

The passing score is determined by PMBA Advisory Council consist of experienced professionals to ensure the validity and reliability of the examination. The standard is the basic knowledge level than can reasonably be expected of individuals with basic competence about Medical Billing. Test Takers will not be measured against the performance of other Test Takers taking the examination. All questions in the examination are developed, tested, and approved by PMBA Advisory Council, to ensure that the ambiguity is eliminated from examination questions, and the questions address concepts apposite for Test Takers for the examination and establish the reliability of certification.

Examination Results

Test Taker will receive their test score immediately upon completion of their examination and also receive an e-mail from PMBA within one week from the date of examination about the result of examination, score report, how they performed on the examination as a whole, performance on each section of examination. Results are formulated using preset criteria by PMBA to ensure validity and reliability.

The scores represent the percentage of questions answered correctly for each section (out of number of questions in each section) and are provided to assist Test Takers in determining how well they scored in each section as well as what areas Test Takers need to focus more.

To ensure the confidentiality of examination results, actual scores will not be released to via telephone, fax or by e-mail to any one except the Test Taker. Scores will not be sent to employers, school, or any other institution under any circumstances. Names of the Test Takers who do not pass the examination are confidential and not revealed under any circumstances, except by legal compulsory process.

PLEASE DO NOT CALL PMBA for results

Special Needs

All of our HOST Locations are required to abide by federal and local laws that require reasonable accommodations for an individual with a disability in job-related test situations (i.e. The American Disabilities Act). If you have a special need, please email Testing Support Team support@pmba.com to register for your exam. You may be required to submit a form that identifies your limitations and the supportive resource you are requesting.

Examination Information

Identification Required to appear for Examination

In order to be admitted for testing, you must have two forms of identification; one must be a photo ID. Acceptable forms of photo ID include: State issued driver’s license, passport, military identification, an employee identification card or a student picture ID from an accredited college or university.

The following forms of non-photo ID are acceptable: credit card, check cashing card or a bank debit card. A social security card is not an acceptable form of identification.

Without acceptable forms of ID, Test Taker/s will not be allowed to appear test and shall/will forfeit the application fee.

Examination Rule

Test Area Admission

Certified Proctor shall only permit people actively taking a test into the testing area. Anyone accompanying you must wait in the lobby area of the HOST location. Unaccompanied children are prohibited from waiting in the testing or lobby area.

Personal items may not be accessed during the test session. Personal items include: bags, wallets, purses, briefcases, watches, books, beepers, cell phones, palm pilots and calculators. You should, however, keep your identification with you at all times.

No tobacco products, food, drink, or chewing gum are allowed in the testing area.

During the test session

Do not attempt to browse outside your testing window or access the Internet. This will cause your session to log out and a restart by your proctor will be required.

Do not click the “Submit” button until you have completed the Entire test.

It is not recommended that you take a break during the testing session. If you must take a break, the clock will continue to run, decreasing the amount of time you have to complete the test. Total test time of 180 minutes is inclusive of break time.

If you choose to take a break, you must notify the proctor. Proctor will terminate your examination if you leave the testing area without notify your proctor. You are not allowed to access your personal belongings during a break.

Cancellation / Fee Refund

The examination fee is refundable (minus a $75.00 processing fee) if Test Taker notifies PMBA of his/her cancellation and refund request via email at least 72 hours prior to the examination date. Test Taker who does not notify or request for refund and does not appear for examination forfeits full fees.

Feedback

Feedback on Testing Experience After completing the examination. Test Takers will be asked to complete a short evaluation of the testing experience. Comments will be reviewed, but responses to individual Test Takers will not be provided.

Notification of Results

For all of ICA certification exams, results are displayed immediately after submission of the exam and feedback and results are sent to you via email within a week of completion of the exam.

Retesting

In the event that a Test Taker fails his or her first attempt to pass the certification test, PMBA requires a waiting period of at least 10 days between the first and second attempt to pass that same test.

Test Takers unsuccessful on the examination are permitted a retake at free of cost for the next exam administration. However, for the applicant’s third attempt, full examination fees have to be paid in full.

Appeals Policy

Test Takers may appeal the results of eligibility determination or the any query related to examination within 15 days of the date of the results. Test Taker needs to send e-mail at exams@pmbausa

After Successful Completion

Upon passing the certification exam, you will receive a congratulatory email. The following will be included in this email:

(a) Passing Score

(b) Credential Anniversary Date (The date you passed the exam).

(c) Notice of listing on PMBAUSA.com website

Successful Test Takers will receive the numbered certificate that is suitable for framing with scores within 6-8 weeks.

The Test Taker’s name will appear on the certificate exactly as completed on the Online Registration at

Individuals seeking a replacement certificate because the original was lost, stolen, destroyed, or the name on the certificate has changed, are required to contact our Testing Support Team at support@pmbausa.com.

Appropriate Use of the Certification

Successful Test Takers are only allowed to use the credential they have earned by passing the relevant exam. You may represent yourself with the earned credential from PMBA as long as you continue to maintain your certification status according to the PMBA.

Inappropriate/Improper Use

The following are construed as inappropriate/improper use of the credential earned through PMBAUSA:

(a) Licensed Medical Biller

(b) Licensed Medical Biller

(c) Certified Professional Biller

Suspension of Certification

Should the certification be suspended or withdrawn for any reason, the individual must immediately cease the use of the certification designation and acronym on stationary, websites, business cards, and any and all promotional materials. Questions regarding the use of certification designation should be emailed to exams@pmbausa.com

Copyright Information

All proprietary rights to PMBA certification examinations, including copyright, are held by PMBAUSA. In order to protect the validity of the scores reported, Test Takers must adhere to strict guidelines regarding proper conduct in handling these copyrighted proprietary materials. The law strictly prohibits any attempt to reproduce all or part of the PMBA certification exams, Test Taker handbook, CP < B Official Study Guides or any other material published on PMBA. Such attempts may include, but are not limited to: removing materials from the testing room; aiding others by any means in reconstructing any portion of the examination; and selling, distributing, receiving, or having unauthorized possession of any portion of the examination. Alleged copyright violations will be investigated and, if warranted, prosecuted to the fullest extent of the law. It should be noted that examination scores might become invalid in the event of this type of suspected breach. Permanent revocation of certification may occur if allegations are substantiated.

Test taker rights

(a) Be informed of your rights and responsibilities as a test taker.

(b) Be treated with courtesy, respect, and impartiality, regardless of your age, disability, ethnicity, gender, national origin, religion, sexual orientation, or other personal characteristics.

(c) Be tested with measures that meet professional standards and that are appropriate, given the manner in which the test results will be used.

(d) Receive written explanation prior to testing about the purpose(s) for testing, the kind(s) of tests to be used, if the results will be reported to you or to others, and the planned use(s) of the results. If you have a disability, you have the right to inquire and receive information about testing accommodation.

(e) Know in advance of testing when the test will be administered, if and when test results will be available to you, and if you are expected to pay a fee for testing services.

(f) Have your test administered and your test results interpreted by appropriately trained individuals who follow a professional code of ethics.

(g) Know the consequences of taking or not taking the test, fully completing the test, or canceling the scores. You may need to ask questions to learn these consequences.

(h) Receive a written explanation of your test results within a reasonable amount of time after testing and in commonly understood terms.

(i) Have your test results kept confidential to the extent allowed by law.

(j) Present concerns about the testing process or your results, and receive information about procedures that will be used to address such concerns

Test Taker Responsibilities

(a) It is the responsibility of the Test Taker to read the entire content of this Handbook before applying for the examination. This Guide contains current information about the policies and procedure of PMBA certification program.

(b) Read or listen to your rights and responsibilities as a test taker.

(c) Treat others with courtesy and respect during the testing process.

(d) Ask questions prior to testing if you are uncertain about why the test is being given, how it will be given, what you will be asked to do, and what will be done with the results.

(e) Read or listen to descriptive information in advance of testing and listen carefully to all test instructions. You should inform PMBA before scheduling your test if you wish to receive a testing accommodation, or if you have a physical condition or illness that may interfere with your performance on the test.

(f) Know when and where the examination will be held, pay for the examination if required, appear on time with any required materials (for example, valid identification and codebooks, if allowed), and be ready to take examination.

(g) Follow the test instructions you are given and represent yourself honestly during the testing.

(h) Be familiar with and accept the consequences of not taking the test, should you choose not to take the test.

(i) Inform appropriate person(s) if you believe that testing conditions affected your results.

(j) Ask about the confidentiality of your test results, if this aspect concerns you.

(k) Present concerns, if you have any, about the testing process or results in a timely, respectful way.

(l) It is the responsibility of the Test Taker to know of all deadlines associated with the certification process.

Examination Preparation

PMBAUSA offers the following suggestion to prepare for the examination:

Plan your studies based on the examination outline, the content areas you have a good understanding of and use every day, you may only need to do a quick review to prepare for examination, whereas in areas in which you are less familiar, you may decide that you need more in-depth studying or training.
Go through the study guide thoroughly for preparing for the examination, it must be noted that the study guide is but one resource and should not be only approach studying holistically, Test Takers can refer other coding manuals and material to prepare for the examination.
Time your test, you may not time your test first, but eventually use a watch to time your test, so that while appearing for the examination you should not run out of time halfway through your exam.
In case you have any clarification or need help in preparing for the examination, please take help of our experts. You can e-mail at exams@pmbausa.com
It is advisable not mandatory to find a study group for pear to pear learning.
Don’t try to do too much in a limited time, study at your own pace and try to understand the concept first of the new coding conventions.
Make a note of important point go through it before the examination.

Principles of Conduct

The Principles of Conduct are intended to serve as a framework within which professionals certified with PMBA perform their duties and to serve as a foundation upon which professionalism in the field of Healthcare Information Management can be promoted. These Principles of Conduct promote and maintain the highest standards of service and personal conduct. Adherence to these standards is expected to assure public confidence in the integrity and service of patient access professionals.

Work with honor and dignity to myself, the profession and the Association
Refuse to participate in or conceal unethical practices or procedures in the professional relationship with individuals or organizations
Collaborate and cooperate with other health professions and organizations
Strive to increase the profession’s body of systematic knowledge and individuals competency through continued self-improvement
Represent truthfully and accurately professional credentials, education, and experience in any official transaction or notice, including other positions and duality of interest.

Test Taker Handbook