Cms 1500 claim form - Study guides, Class notes & Summaries

CRCR EXAM WITH CORRECT CHOICES, CERTIFIED AND VERRIFIED What are collection agency fees based on? - CORRECT ANSWER-A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - CORRECT ANSWER-Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - CORRECT ANSWER-Case rates What customer service improvements might improve the patie...

Medical Billing and Coding Practice Test with Complete Solutions Which of the following Medicare policies determines if a particular item or service is covered by Medicare? National Coverage Determination (NCD) Which of the following is considered the final determination of the issues involving settlement of an insurance claim? Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information Encounter Form A patient comes to the hospital for ...

Which of the following must a patient sign prior to an insurance claim being processed? a. the HIPAA waiver form b. a referral form c. an Authorization to Release Information d. the actual insurance claim form (Ans- c. an Authorization to Release Information Which of the following patient information is needed to determine a Medicaid sliding fee scale. Select the three (3) correct answers. a. amount of the bill b. occupation c. number of dependents d. poverty level e. salary (Ans...

1-day payment window rule - Answer a Medicare requirement similar to the day payment window rule that applies to inpatient poychiatric hosp tals, inpatient rehabilitation facilities, long term care facilities, and chil dren's and cancer hospital. 3-day payment window rule - Answer a Medicare requirement that all diagnostic and clinically related non-diagnostic outpatient services provided with in three days of an inpatient admission must combined the inpa- tient claim when they are provided ...

Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Which of the following should a medical assistant instruct a patient to do before a scheduled pulmonary function test? a. Consume dairy products in limited amounts c. Undergo a nebulizer treatment 3 hr before the test begins. b. Refrain from using bronchodilators. d. Perform a cardiac stress test prior to arrival. 2. Which of the following should a medical assistant use whe...

NHA,CBCS Study Guide (2024/ 2025 Update) | Questions and Verified Answers| 100% Correct| A Grade Explain the difference between fraud and abuse? Answer: Fraud - intentionally misrepresenting services rendered for the purpose of receiving a higher payment Abuse - refers to practices that are often done unknowingly as a result of poor business practices, directly, or indirectly resulting in unnecessary costs to the program through improper payments QUESTION What is the di...

Which of the following is considered the final determination of the issues involving settlement of an insurance claim? -Correct Answer Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information is called which of the following? -Correct Answer Encounter form A patient comes to the hospital for an inpatient procedure. Which of the following hospital staff members is responsible for the initial patient interview, obtaining demographic and insurance i...

NHA CBCS CERTIFICATION EXAM QUESTIONS AND ANSWERS 100% PASS Which of the following is considered the final determination of the issues involving settlement of an insurance claim? - Correct Answer ️️ -Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information is called which of the following? - Correct Answer ️️ -Encounter form A patient comes to the hospital for an inpatient procedure. Which of the following hospital staff members is respo...

Joe and Mary are a married couple and both carry insurance from their employers. Joe was born on February 23, 1977 and Mary was born on April 4, 1974. Using the birthday rule, who carries the primary insurance for their children for billing? A. Joe, because he is the male head of the household. B. Mary, because her date of birth is the 4th and Joe's date of birth is the 23rd. C. Mary, because her birth year is before Joe's birth year. D. Joe, because his birth month and day are before Mary...

HCFA stands for : - Health Care Financing Administration The HCFA-1500 paper health insurance form was developed in______ by ________________ : - 1975; Health Care Financing Administration (HCFA) The HCFA claim form was developed to be used by providers for what purpose? - Billing Medicare for outpatient services HCFA changed its name to what in July of 2001? - Center for Medicare and Medicaid Services (CMS) HCFA-1500 claim form was changed to this in July of 2001 : - CMS-1500 Universal C...