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(Based on Previous Test)

1. Fee-for-service claims

are generally accepted nationwide by most commercial health insurance companies.

In Block 1 of the CMS-1500 claim

you should always place an X in the Other box when filing a commercial insurance claim.

Do not enter hyphens or spaces.

when entering a policyholder's commercial policy or group number

The shaded area in each line

is used to enter supplemental information to support reported services if instructed by the payer to enter such information

Disability insurance

reimburses individual for lost income as well as health care expenses

Most health insurance plans

are secondary to liability insurance.

Modifications are made to the CMS-1500 claim instructions

when patients are covered by primary and secondary or supplemental health insurance plans

Submit just one CMS-1500 claim

when the same payer issues the primary and secondary or supplemental policies

Although commercial claims completion instructions are generally recognized nationwide

it is important tocheck with each payer to determine if they require alternate information to be entered on the claim

Information is entered in Blocks 9 through 11 and just one just one claim is submitted

if the same payer provides both primary and secondary/supplemental coverage

The base period for a disability claim covers

12 months

Block 32 must be filled out

if services were provided at a location other than the provider's office or the patient's home, such as a hospital, outside laboratory facility, skilled nursing facility, or DMEPOS supplier

When filling out the CMS-1500 claim form, the policyholder's name should appear as

Last name - First name - Middle initial (separated with commas)

The patient's birth date should appear on the CMS-1500 claim as


Leave Block 11a blank

if the policyholder's gender is unknown

Block 24 of the CMS claim is limited to reporting how many services


Supplemental health insurance plans usually cover

deductibles,copayments, coinsurance expenses

Liability Insurance

insurance that covers losses to a third party caused by the insured, by an object owned by the insured, or on premises owned by the insured.

The shaded area in each line is used to

enter supplemental information to support reported services, enter supplemental information when requested by the payer

In Block 33 of the CMS-1500 claim, the correct way to enter the provider's zip code is


If a patient is covered by two different policies, the correct procedure for submitting the claim would be

the primary submitted first, followed by secondary after primary payment

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