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The procedure performed for definitive treatment of the principal diagnosis, or the procedure that is most closely related to the principal diagnosis is the:
Insured Unique Identifier
What number is assigned by the insurance company or government program to identify the individual who is covered under the plan and reported in FL 60 on the CMS-1450(UB-04)?
Reimbursement is determined based on the information reported on the claim form.
What is the relationship between the claim form and reimbursement?
Direct transmission and through a clearinghouse.
Two ways that the electronic claims process can be accomplished are:
Section 1 FL 8 (B), 9 (A-E)
What section and fields on the CMS-1450(UB-04) are used to record the patient name and address?
An insurance claim form is used by providers to submit charges for medical services and supplies to various third-party payers
Computer templates are used to define all the information required on the claim for the payer, and specific payer edits may also be programmed on templates.
FL 81 of the CMS 1450(UB-04) to report additional condition or occurrence codes describing more information.
FL 67-86 on the CMS-1450(UB-04) are used to record diagnosis codes that describe te admitting diagnosis, principal and other diagnosis, external cause of injury(of the condition for which the patient is admitted), and the principal and other procedures.
Treatment authorization code
A payer provides an authorization number that is reported on the claim when services are authorized. The number is recorded on the CMS-1450(UB-04) in FL 63 and is called a(n):
The need for various versions of software or a clearinghouse to submit a claim.
Disadvantages of electronic claim submission include:
Charge capture data are gathered during the patient visit and used to print a detailed itemized statement and to complete which form locators on the claim form?
Optical scanning replaces te process of having to input data manually from the claim form into a computer system.
Scanning has improved claim processing in the following ways:
FL 8-41 on the CMS-1450(UB-04) is used to record information regarding the facility, when the patient was admitted and discharged, the patient's name and address, as well as other information regarding the patient visit.
The term used to describe the process in which a claim form is scanned and data on the claim are transferred into a computerized system.
The term used to describe the payment received for rendering services and supplies to a patient.
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