Marge has Medicaid and goes to see the chiropractor once a week. The chiropractor takes Medicaid but informs Marge that she has a $25 copay for each visit. Marge's insurance card lists no copay. When questioned, the billing office tells Marge that her insurance only reimburses $17 per chiropractic visit and it would cost them more to bill her insurance than it would just to have her pay--and it's only $25. According to Medicaid regulations:

The American Academy of Professional Coders (AAPC) provides training and credentialling for medical billers across the United States. After passing the AAPC medical billing exam, a medical biller earns the Certified Professinal Biller (CPB) credential. The medical billing exam has 200 multiple choice questions and five hours and forty minutes is given to complete the exam.