Cms 1500 form - Study guides, Class notes & Summaries

Which of the following Medicare policies determines if a particular item or service is covered by Medicare? - CORRECT ANSWER National Coverage Determination (NCD) A patient's employer has not submitted a premium payment. Which of the following claim statuses should the provider receive from the third-party payer? - CORRECT ANSWER Denied A billing and coding specialist should routinely analyze which of the following to determine the number of outstanding claims? - CORRECT ANSWER Agin...

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 ...

NHA CBCS Exam Pep (Latest 2024/ 2025) | Questions and Verified Answers| 100% Correct| Grade A Q: A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has Medicare as her primary insurance. Which form is required so the patient knows she may be responsible for payment? Answer: Advanced Beneficiary Notice is a form that is required for Medicare recipients Q: Which of the following should the BCS complete to be reimbursed for the provider's services? ...

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...

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...

(ASCA) The Administrative simplification compliance act - requires that claims to medicare be transmitted electronically, unless clearinghouse is being used by a provider to submit claims a draft may be completed on paper (ASCA) - The Administrative simplification compliance act (NUCC) - National Uniform Claim Committee (NUCC) National Uniform Claim Committee - Organization that maintains the CMS-1500 form any new version would have to be approved by the White House Office Management and B...

where is epithelial tissue located? - the lining of the nose what type of tissue is classified as hard or soft? - connective what is the primary function of muscle tissue? - to produce moivement blood is classified as what type of tissue? - connective what is transverse plane?. - horizontal cut what is a midsagittal plane? - vertical cut What is often included on a medical history form? - Allergies When can medical records be released to the patients husband? - When the patient has given...

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...

Facility fee billing- HOPPS- used for nonmedicare B recognized provider who is employed or contrated by hospital health system supervising physician must be the in the BUILDING APC Code 5012 with G0463 "Incident to" or Clinic Billing- Must be in the same SUITE or office CMS Annual Wellness Visit - Initial Preventive Physical Exam only by physician or NP/PA::: NOT PHARMACIST G0402 CMS AWV Initial- can be done by pharm G0438 CMS AWV Follow-up G0439 For...

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 ...