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CMS 1500 claim form
Terms in this set (36)
_________ means the patient has authorized the payment of benefits directly to the provider
Assignment of benefits
Which of the following is not included in the insurance carrier's role ?
Collect a copayment from the physician
The date in block 14 is the date
onset of illness
A Superbill/encounter form provides which of the following?
Procedures and charges
The federal tax ID number (box 25) for the provider filing the claim can be presented as
SSN and EIN
Which of the following is recommended when a claim is not paid within thirty days ?
Investigate the carrier's policies regarding usual turnaround time.
Which of the following is the universal health insurance claim form for the medical office ?
________ insurance carriers can be identified when using the CMS-1500 form.
A claim that is printed and mailed to the carrier is called a(n) _______ copy
A physician who requests a consultation from a specialist is a
A secondary health plan is noted in which block ?
The definition of electronic data interchange is
Transferring data back and forth between two or more entities
Which of the following steps to medical billing should be performed prior to rendering medical services?
Verify the patient's eligibility for insurance coverage and collect patient insurance information
The claim's process is limited to _______ procedures per office visit
Which portion of the claim form contains physician or facility information?
The last part
The patient's (permanent) address and phone number are entered in which block ?
Verification of insurance benefits is usually done by
calling the insurance carrier
Which of the following is an example of fraud ?
Altering a patient's chart to increase the amount reimbursed and coding for procedures not completed during the office visit
Determining which insurance to bill first vs second is referred to as
Coordination of benefits
To prepare for the claim process, the medical assistant should collect all of the following EXCEPT ?
The policy number for only the primary carrier
Block 1 of the CMS-1500 contains what information?
Type of insurance coverage
A ________________ is helpful to follow up on unpaid insurance claims
What is meant by "other insured" on the claim form ?
The secondary plan covering the patient
The physician's office place-of-service code is
For which of the following reasons might a claim be denied ?
No preauthorization has been obtained.
The claim is not for a covered benefit.
The patient has a preexisting condition that is not covered.
Services were provided before the waiting period ended.
*** All of these
The insured's address in block 7 refers to the ______________ address.
A provider is a
When using ICD-10-CM codes, which of the following will occur when digits are omitted ?
Which of the following would be valid entry for block 24e ?
On completion of the processing of the claim, the insurance company sends what to the insured person?
Separating the components of a procedure and reporting them as billable codes with charges in order to increase reimbursement rates is known as what ?
What is necessary in order to authorize release of medical information to an insurance carrier ?
A medical release from the patient is needed
Which of the following is the claim form used for filing inpatient admissions claims ?
Which of the following occurs when the insurance carrier is deliberating billed a higher rate service than what was performed to order for the provider to obtain greater reimbursements?
How many diagnostic codes can be used on the CMS 1500 form ?
Which of the following should be used to check for patient eligibility ?
Point of service device
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