Exam 5: Claim Submission Methods

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What is meant by "assigning benefits"?

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One of the recent technological advances that makes verification of patient insurance eligibility easier and faster is the:

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If the decision is made to go direct to the carrier,there will be multiple _______ that occur when a computer is programmed to automatically connect to another computer.

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The intent of HIPAA's Administrative Simplification legislation was to provide consumers with lower healthcare costs.

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The paper claim form approved by the AMA Council on Medical Services,which was subsequently adopted by all government healthcare programs.

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Small providers that are not computerized can use the paper version of the CMS-1500.

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HIPAA Standards Version ____ addresses many of the limitations in the former version and supports the reporting of national provider identifiers (NPIs)and the new ICD-10 codes.

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The HIPAA Administrative Simplification Compliance Act (ASCA)prohibits Medicare from paying claims that are not submitted electronically,with certain exceptions.

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A business entity that specializes in consolidating claims received from providers and transmitting them in batches to each respective third-party payer.

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The _________ may grant a waiver from the mandatory electronic claims submission rule.

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The two main sections of the CMS-1500 are ____________ and ____________.

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After the paper form has been completed according to the applicable payer guidelines,it should be ____________ to check for errors.

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According to HIPAA,which of the following code sets is acceptable for the electronic transmission of healthcare data?

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Complete this statement: "A complete medical record should _______."

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Documents needed to generate an insurance claim include all of the following,except a:

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Additional software may be required to send claims directly to a third-party payer.

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List the five documents needed for filing an insurance claim.

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HIPAA's new 5010 transaction standards only impact __________ claim submissions.

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If a medical facility has only one employee but is utilizing some type of electronic software,the office must be in compliance with HIPAA's privacy rules and regulations.This is referred to as the ___________ rule.

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Direct claim submission is considered the best method if most claims are being sent to a single carrier.

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