Understanding Health Insurance

Health & Kinesiology

Quiz 11 :

Essential Cms-1500 Claim Instructions

Quiz 11 :

Essential Cms-1500 Claim Instructions

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Hospital inpatient charges are reported on the __________ claim.
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Answer:

D

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When reporting procedures and services on the CMS-1500, list one procedure per line, starting with line one of Block 24. To report more than six procedures or services for the same date of service, __________.
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Answer:

B

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Diagnosis pointer letters A-L are preprinted in Block 21 of the CMS-1500 claim to allow for entry of __________ codes, and they are reported in Block 24E.
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Answer:

C

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The optical scanning process uses a device that converts __________ characters into text that can be viewed by an optical character reader (OCR).
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When entering a fee in Blocks 24F, 28, or 29, enter __________ in the cents column.
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Surgeon's charges for inpatient and outpatient surgery are billed according to a global fee, which means that __________ cover(s) presurgical evaluation and management, initial and subsequent hospital visits, surgical procedure, the discharge visit, and uncomplicated postoperative follow-up care in the surgeon's office.
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Which of the following health care professionals is permitted to bill a physician when that physician provides direct supervision of procedures/services?
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Which occurs when a physician in the community refers a patient to the hospital for observation, bypassing the clinic or emergency department?
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Provider services for inpatient care are billed on a fee-for-service basis, and service results in a unique and separate charge designated by a __________ or HCPCS level II service/procedure code.
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Postoperative complications requiring a return to the operating room for surgery related to the original procedure are billed as an additional procedure, and the additional procedure is linked to __________.
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Block 33 of the CMS-1500 claim requires entry of the name, address, and telephone number of the billing entity, which is the __________.
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Supplemental plans usually cover the deductible and copay or coinsurance of a primary health insurance policy. Which is the best known supplemental plan?
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Which was developed by the Centers for Medicare and Medicaid Services to assign the unique health care provider and health plan identifiers and to serve as a database from which to extract data?
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Patients sign Block 13 of the CMS-1500 claim to instruct the payer to directly reimburse the provider. This concept is called __________.
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When completing the CMS-1500, enter a __________ for the dollar sign or decimal in all charges or totals and parentheses surrounding the area code in a telephone number.
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The CMS-1500 paper claim was designed to accommodate optical scanning of __________ claims.
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Which is considered a nonphysician practitioner?
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Which is a licensed physician in good standing who, according to state regulations, engages in the direct management of nonphysician practitioners whose duties are encompassed by that physician's scope of practice?
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HIPAA regulations require all payers to accept __________ attachments.
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When a person uses a title such as Sr., Jr., II, or III, __________.
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