Question 1

The appropriate method for entering the date of service (January 4, 2xxx) on a claim form is:

Accepted Answer

A)  1/4/xx 
B)  01042xxx 
C)  01-04-xx 
D)  01 04 xx 
A)  1/4/xx 
B)  01042xxx 
C)  01-04-xx 
D)  01 04 xx

Question 2

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text.
-What is the treating physician's NPI number?

Accepted Answer

The answer of For the following questions, refer to the...

Question 3

Match the type of insurance claim with the correct description.

-A Medicare claim that contains complete, necessary information but is illogical or incorrect.

Accepted Answer

A) Clean claim 
B) Dirty claim 
C) Electronic claim 
D) Incomplete claim 
E) Invalid claim
F)Paper claim
G)Pending claim
H)Rejected claim 
A) Clean claim 
B) Dirty claim 
C) Electronic claim 
D) Incomplete claim 
E) Invalid claim
F)Paper claim
G)Pending claim
H)Rejected claim

Question 4

A physically clean claim is one that has all of the necessary information required reported on it.

Accepted Answer

A) True 
 B)False

Question 5

The AMA was named in the administrative simplification of the HIPAA of 1996 as the authoritative voice regarding national standard content for submission of claims.

Accepted Answer

A) True 
 B)False

Question 6

To conform to CMS-1500 OCR guidelines,

Accepted Answer

A)  do not fold insurance claim forms when mailing. 
B)  do not use symbols with data on insurance claim forms. 
C)  do not strike over errors when making a correction on an insurance claim form. 
D)  all of the above. 
A)  do not fold insurance claim forms when mailing. 
B)  do not use symbols with data on insurance claim forms. 
C)  do not strike over errors when making a correction on an insurance claim form. 
D)  all of the above.

Question 7

Match the reason that the insurance claim was rejected with the possible solution to the problem.

-Total amounts do not equal itemized amounts charged.

Accepted Answer

A) Proofread numbers carefully from source documents. 
B) Check for Sr., Jr., correct birth date, and verify the insured. 
C) Refer to an updated diagnostic codebook and review the patient record. 
D) Verify with the patient's medical record that all dates of service are listed and accurate. 
E) Verify that the place of service is correct for the submitted procedure code(s) and fill in correct service code.
F)Refer to the current procedure codebooks and verify the coding system used by the insurance company.
G)Verify and submit valid modifiers with the correct procedure codes for which they are valid.
H)Total all charges on each claim, recheck the math, and verify amounts with the patient account.
I)Obtain data from patient during the first office visit on which company is the primary insurer.
J)Submit all attachments with patient's name and insurance identification number. 
A) Proofread numbers carefully from source documents. 
B) Check for Sr., Jr., correct birth date, and verify the insured. 
C) Refer to an updated diagnostic codebook and review the patient record. 
D) Verify with the patient's medical record that all dates of service are listed and accurate. 
E) Verify that the place of service is correct for the submitted procedure code(s) and fill in correct service code.
F)Refer to the current procedure codebooks and verify the coding system used by the insurance company.
G)Verify and submit valid modifiers with the correct procedure codes for which they are valid.
H)Total all charges on each claim, recheck the math, and verify amounts with the patient account.
I)Obtain data from patient during the first office visit on which company is the primary insurer.
J)Submit all attachments with patient's name and insurance identification number.

Question 8

Match the type of insurance claim with the correct description.

-An insurance claim that is submitted with errors.

Accepted Answer

A) Clean claim 
B) Dirty claim 
C) Electronic claim 
D) Incomplete claim 
E) Invalid claim
F)Paper claim
G)Pending claim
H)Rejected claim 
A) Clean claim 
B) Dirty claim 
C) Electronic claim 
D) Incomplete claim 
E) Invalid claim
F)Paper claim
G)Pending claim
H)Rejected claim

Question 9

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text.
-What is the insured's ID number?

Accepted Answer

The answer of For the following questions, refer to the...

Question 10

According to OCR guidelines, all information on the CMS-1500 claim form should be typed in uppercase.

Accepted Answer

A) True 
 B)False

Question 11

The CMS-1500 is known as the

Accepted Answer

A)  COMB-1. 
B)  basic paper claim. 
C)  attending physician's statement. 
D)  electronic claim. 
A)  COMB-1. 
B)  basic paper claim. 
C)  attending physician's statement. 
D)  electronic claim.

Question 12

Health insurance specialists should be familiar with the paper claim, as there may be occasions where the practice experiences technical _____________ and is unable to submit claims electronically.

Accepted Answer

The answer of Health insurance specialists should be familiar with...

Question 13

When a non-physician practitioner sees a patient in the office, while another physician in the practice provides direct supervision, the claim can be billed to Medicare using the physician's NPI, referred to as ______ services.

Accepted Answer

The answer of When a non-physician practitioner sees a patient...

Question 14

Signature on file may be indicated on the CMS-1500 claim form when a signed assignment of benefits form is retained in the patient's health record.

Accepted Answer

A) True 
 B)False

Question 15

When completing a claim form for a patient who has group insurance coverage, it is important to complete all information regarding the patient's ___.

Accepted Answer

The answer of When completing a claim form for a...

Question 16

Match the reason that the insurance claim was rejected with the possible solution to the problem.

-Operative report is missing from the insurance claim.

Accepted Answer

A) Proofread numbers carefully from source documents. 
B) Check for Sr., Jr., correct birth date, and verify the insured. 
C) Refer to an updated diagnostic codebook and review the patient record. 
D) Verify with the patient's medical record that all dates of service are listed and accurate. 
E) Verify that the place of service is correct for the submitted procedure code(s) and fill in correct service code.
F)Refer to the current procedure codebooks and verify the coding system used by the insurance company.
G)Verify and submit valid modifiers with the correct procedure codes for which they are valid.
H)Total all charges on each claim, recheck the math, and verify amounts with the patient account.
I)Obtain data from patient during the first office visit on which company is the primary insurer.
J)Submit all attachments with patient's name and insurance identification number. 
A) Proofread numbers carefully from source documents. 
B) Check for Sr., Jr., correct birth date, and verify the insured. 
C) Refer to an updated diagnostic codebook and review the patient record. 
D) Verify with the patient's medical record that all dates of service are listed and accurate. 
E) Verify that the place of service is correct for the submitted procedure code(s) and fill in correct service code.
F)Refer to the current procedure codebooks and verify the coding system used by the insurance company.
G)Verify and submit valid modifiers with the correct procedure codes for which they are valid.
H)Total all charges on each claim, recheck the math, and verify amounts with the patient account.
I)Obtain data from patient during the first office visit on which company is the primary insurer.
J)Submit all attachments with patient's name and insurance identification number.

Question 17

Medicare providers who charge patients a fee for supplies and equipment such as crutches, urinary catheters, and walkers must send the claims to

Accepted Answer

A)  their regional fiscal intermediary. 
B)  a specific DME fiscal intermediary. 
C)  TRICARE. 
D)  the patient. 
A)  their regional fiscal intermediary. 
B)  a specific DME fiscal intermediary. 
C)  TRICARE. 
D)  the patient.

Question 18

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text.
-Who is the physician who treated this patient?

Accepted Answer

The answer of For the following questions, refer to the...

The appropriate method for entering the date of service (January 4, 2xxx) on a claim form is:

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text. -What is the treating physician's NPI number?

Match the type of insurance claim with the correct description. -A Medicare claim that contains complete, necessary information but is illogical or incorrect.

A physically clean claim is one that has all of the necessary information required reported on it.

The AMA was named in the administrative simplification of the HIPAA of 1996 as the authoritative voice regarding national standard content for submission of claims.

To conform to CMS-1500 OCR guidelines,

Match the reason that the insurance claim was rejected with the possible solution to the problem. -Total amounts do not equal itemized amounts charged.

Match the type of insurance claim with the correct description. -An insurance claim that is submitted with errors.

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text. -What is the insured's ID number?

According to OCR guidelines, all information on the CMS-1500 claim form should be typed in uppercase.

The CMS-1500 is known as the

Health insurance specialists should be familiar with the paper claim, as there may be occasions where the practice experiences technical _____________ and is unable to submit claims electronically.

When a non-physician practitioner sees a patient in the office, while another physician in the practice provides direct supervision, the claim can be billed to Medicare using the physician's NPI, referred to as ______ services.

Signature on file may be indicated on the CMS-1500 claim form when a signed assignment of benefits form is retained in the patient's health record.

When completing a claim form for a patient who has group insurance coverage, it is important to complete all information regarding the patient's ___.

Match the reason that the insurance claim was rejected with the possible solution to the problem. -Operative report is missing from the insurance claim.

Medicare providers who charge patients a fee for supplies and equipment such as crutches, urinary catheters, and walkers must send the claims to

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text. -Who is the physician who treated this patient?

Role of an Insurance Billing Specialist

Compliance, Privacy, Fraud, and Abuse in Insurance Billing

Basics of Health Insurance

Medical Documentation and the Electronic Health Record

Diagnostic Coding

Procedural Coding

The Electronic Claim

Receiving Payments and Insurance Problem Solving

Office and Insurance Collection Strategies

The Blue Plans, Private Insurance, and Managed Care Plans

Medicare

Medicaid and Other State Programs

Tricare and Veterans Health Care

Workers Compensation

Disability Income Insurance and Disability Benefit Programs

Hospital Billing

Seeking a Job and Attaining Professional Advancement

Filters

Exam 7: The Paper Claim: Cms-1500 02-12

The appropriate method for entering the date of service (January 4, 2xxx) on a claim form is:

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text. -What is the treating physician's NPI number?

Match the type of insurance claim with the correct description. -A Medicare claim that contains complete, necessary information but is illogical or incorrect.

A physically clean claim is one that has all of the necessary information required reported on it.

The AMA was named in the administrative simplification of the HIPAA of 1996 as the authoritative voice regarding national standard content for submission of claims.

To conform to CMS-1500 OCR guidelines,

Match the reason that the insurance claim was rejected with the possible solution to the problem. -Total amounts do not equal itemized amounts charged.

Match the type of insurance claim with the correct description. -An insurance claim that is submitted with errors.

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text. -What is the insured's ID number?

According to OCR guidelines, all information on the CMS-1500 claim form should be typed in uppercase.

The CMS-1500 is known as the

Health insurance specialists should be familiar with the paper claim, as there may be occasions where the practice experiences technical _____________ and is unable to submit claims electronically.

When a non-physician practitioner sees a patient in the office, while another physician in the practice provides direct supervision, the claim can be billed to Medicare using the physician's NPI, referred to as ______ services.

Signature on file may be indicated on the CMS-1500 claim form when a signed assignment of benefits form is retained in the patient's health record.

When completing a claim form for a patient who has group insurance coverage, it is important to complete all information regarding the patient's ___.

Match the reason that the insurance claim was rejected with the possible solution to the problem. -Operative report is missing from the insurance claim.

Medicare providers who charge patients a fee for supplies and equipment such as crutches, urinary catheters, and walkers must send the claims to

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text. -Who is the physician who treated this patient?

Role of an Insurance Billing Specialist

Compliance, Privacy, Fraud, and Abuse in Insurance Billing

Basics of Health Insurance

Medical Documentation and the Electronic Health Record

Diagnostic Coding

Procedural Coding

The Electronic Claim

Receiving Payments and Insurance Problem Solving

Office and Insurance Collection Strategies

The Blue Plans, Private Insurance, and Managed Care Plans

Medicare

Medicaid and Other State Programs

Tricare and Veterans Health Care

Workers Compensation

Disability Income Insurance and Disability Benefit Programs

Hospital Billing

Seeking a Job and Attaining Professional Advancement

Filters