Exam 11: Physician Medical Billing

The use of the CMS-1500 claim form is: A)mandatory for all physician office claims. B)mandatory for all Medicare claims but optional for private insurance carriers. C)optional for all Medicare claims but mandatory for private insurance carriers. D)optional for all physician office claims.

On the CMS-1500 claim form, the abbreviation EIN refers to: A)Employer Identification Number. B)Employer Identifier for National Coverage. C)Estimated Insurance Number for payment. D)Examination Indicates Nothing.

Physicians bill insurance carriers using a universal form, the __________ claim form.

If a patient has signed a consent document authorizing release of medical information to the insurance carrier, the notation "Signature on File" or "SOF" may be entered in form locator 12.

If a patient is covered by more than one health plan, form locator 11d is answered Yes and form locators 9a-d must be completed.

To submit claims to an insurance carrier, a billing service requires: A)the patient's personal and insurance information. B)a copy of the patient's insurance card. C)the encounter form documenting the diagnosis and services provided. D)all of the above.

A signature stamp should never be used in place of the physician's original signature on a claim form.

The person who is ultimately responsible for payment to the medical office is called the: A)guarantor. B)patient. C)guardian. D)insured.

If needed information is missing from a claim when it is submitted to an insurance carrier, it is referred to as a(n): A)clean claim. B)dirty claim. C)erroneous claim. D)incomplete claim.

How are clearinghouses typically paid by the physician?

The CMS-1500 claim form includes the following number of locators (fields): A)13 B)33 C)52 D)70