Question 1

If the patient will oblige, let the patient direct his or her own insurance form to the insurance company.

Accepted Answer

A) True 
 B)False  False

Question 2

OCR guidelines for the CMS-1500 claim form state

Accepted Answer

A)  it can be photocopied by the physician's office to save the expense of buying huge quantities. 
B)  it can be submitted with handwritten information. 
C)  it should not be photocopied because it cannot be scanned. 
D)  enter all information in lowercase letters. 
A)  it can be photocopied by the physician's office to save the expense of buying huge quantities. 
B)  it can be submitted with handwritten information. 
C)  it should not be photocopied because it cannot be scanned. 
D)  enter all information in lowercase letters. C

Question 3

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text.
-What is the date that the symptoms first presented for the condition treated?

Accepted Answer

03/01/2xxx

Question 4

Presently, most health care organizations send the majority of their claims on paper.

Accepted Answer

A) True 
 B)False

Question 5

Effective ___________, the revised paper claim form (02-12) is required for use by all providers.

Accepted Answer

The answer of Effective ___________, the revised paper claim form...

Question 6

To practice medicine within a state, a physician must obtain a physician's state _____.

Accepted Answer

The answer of To practice medicine within a state, a...

Question 7

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text.
-What is the procedural code that was submitted on this claim form, describing the services provided to this patient?

Accepted Answer

The answer of For the following questions, refer to the...

Question 8

Office visits may be grouped on the insurance claim form if each visit

Accepted Answer

A)  is consecutive and uses the same procedure code. 
B)  is consecutive, uses the same procedure code, and results in the same fee. 
C)  uses the same diagnosis code. 
D)  occurs during the same month. 
A)  is consecutive and uses the same procedure code. 
B)  is consecutive, uses the same procedure code, and results in the same fee. 
C)  uses the same diagnosis code. 
D)  occurs during the same month.

Question 9

Abstraction of technical information from patient records may be necessary to support medical ___.

Accepted Answer

The answer of Abstraction of technical information from patient records...

Question 10

List all services on the insurance claim form, including "no charge" services.

Accepted Answer

A) True 
 B)False

Question 11

Match the reason that the insurance claim was rejected with the possible solution to the problem.

-Diagnostic code is missing.

Accepted Answer

A) Proofread numbers carefully from source documents. 
B) Check for Sr., Jr., correct birth date, and verify the insured. 
C) Refer to an updated diagnostic codebook and review the patient record. 
D) Verify with the patient's medical record that all dates of service are listed and accurate. 
E) Verify that the place of service is correct for the submitted procedure code(s) and fill in correct service code.
F)Refer to the current procedure codebooks and verify the coding system used by the insurance company.
G)Verify and submit valid modifiers with the correct procedure codes for which they are valid.
H)Total all charges on each claim, recheck the math, and verify amounts with the patient account.
I)Obtain data from patient during the first office visit on which company is the primary insurer.
J)Submit all attachments with patient's name and insurance identification number. 
A) Proofread numbers carefully from source documents. 
B) Check for Sr., Jr., correct birth date, and verify the insured. 
C) Refer to an updated diagnostic codebook and review the patient record. 
D) Verify with the patient's medical record that all dates of service are listed and accurate. 
E) Verify that the place of service is correct for the submitted procedure code(s) and fill in correct service code.
F)Refer to the current procedure codebooks and verify the coding system used by the insurance company.
G)Verify and submit valid modifiers with the correct procedure codes for which they are valid.
H)Total all charges on each claim, recheck the math, and verify amounts with the patient account.
I)Obtain data from patient during the first office visit on which company is the primary insurer.
J)Submit all attachments with patient's name and insurance identification number.

Question 12

A dirty claim is one that had coffee spilled on it before it was sent to the insurance carrier.

Accepted Answer

A) True 
 B)False

Question 13

Match the reason that the insurance claim was rejected with the possible solution to the problem.

-Patient's name and insured's name are entered as the same when the patient is a dependent.

Accepted Answer

A) Proofread numbers carefully from source documents. 
B) Check for Sr., Jr., correct birth date, and verify the insured. 
C) Refer to an updated diagnostic codebook and review the patient record. 
D) Verify with the patient's medical record that all dates of service are listed and accurate. 
E) Verify that the place of service is correct for the submitted procedure code(s) and fill in correct service code.
F)Refer to the current procedure codebooks and verify the coding system used by the insurance company.
G)Verify and submit valid modifiers with the correct procedure codes for which they are valid.
H)Total all charges on each claim, recheck the math, and verify amounts with the patient account.
I)Obtain data from patient during the first office visit on which company is the primary insurer.
J)Submit all attachments with patient's name and insurance identification number. 
A) Proofread numbers carefully from source documents. 
B) Check for Sr., Jr., correct birth date, and verify the insured. 
C) Refer to an updated diagnostic codebook and review the patient record. 
D) Verify with the patient's medical record that all dates of service are listed and accurate. 
E) Verify that the place of service is correct for the submitted procedure code(s) and fill in correct service code.
F)Refer to the current procedure codebooks and verify the coding system used by the insurance company.
G)Verify and submit valid modifiers with the correct procedure codes for which they are valid.
H)Total all charges on each claim, recheck the math, and verify amounts with the patient account.
I)Obtain data from patient during the first office visit on which company is the primary insurer.
J)Submit all attachments with patient's name and insurance identification number.

Question 14

Match the reason that the insurance claim was rejected with the possible solution to the problem.

-Incorrect modifier.

Accepted Answer

A) Proofread numbers carefully from source documents. 
B) Check for Sr., Jr., correct birth date, and verify the insured. 
C) Refer to an updated diagnostic codebook and review the patient record. 
D) Verify with the patient's medical record that all dates of service are listed and accurate. 
E) Verify that the place of service is correct for the submitted procedure code(s) and fill in correct service code.
F)Refer to the current procedure codebooks and verify the coding system used by the insurance company.
G)Verify and submit valid modifiers with the correct procedure codes for which they are valid.
H)Total all charges on each claim, recheck the math, and verify amounts with the patient account.
I)Obtain data from patient during the first office visit on which company is the primary insurer.
J)Submit all attachments with patient's name and insurance identification number. 
A) Proofread numbers carefully from source documents. 
B) Check for Sr., Jr., correct birth date, and verify the insured. 
C) Refer to an updated diagnostic codebook and review the patient record. 
D) Verify with the patient's medical record that all dates of service are listed and accurate. 
E) Verify that the place of service is correct for the submitted procedure code(s) and fill in correct service code.
F)Refer to the current procedure codebooks and verify the coding system used by the insurance company.
G)Verify and submit valid modifiers with the correct procedure codes for which they are valid.
H)Total all charges on each claim, recheck the math, and verify amounts with the patient account.
I)Obtain data from patient during the first office visit on which company is the primary insurer.
J)Submit all attachments with patient's name and insurance identification number.

Question 15

If several services are being billed on the same insurance claim form, you may "ditto" the dates on each line of service below the first line.

Accepted Answer

A) True 
 B)False

Question 16

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text.
-Was the condition related to an auto accident?

Accepted Answer

The answer of For the following questions, refer to the...

Question 17

An insurance claim form that contains no staples or highlighted areas and on which the bar code area has not been deformed is called

Accepted Answer

A)  a clean claim. 
B)  a paper claim. 
C)  a physically clean claim. 
D)  an error-free claim. 
A)  a clean claim. 
B)  a paper claim. 
C)  a physically clean claim. 
D)  an error-free claim.

Question 18

An insurance claim submitted with errors is referred to as

Accepted Answer

A)  a dingy claim. 
B)  a dirty claim. 
C)  a rejected claim. 
D)  an incomplete claim. 
A)  a dingy claim. 
B)  a dirty claim. 
C)  a rejected claim. 
D)  an incomplete claim.

Question 19

In 2012, the CMS-1500 claim form was revised to version 02-12 to accommodate

Accepted Answer

A)  the change in the name of the Health Care Financing Administration. 
B)  reporting of NPI numbers. 
C)  ICD-10 diagnosis codes. 
D)  Optical scanning. 
A)  the change in the name of the Health Care Financing Administration. 
B)  reporting of NPI numbers. 
C)  ICD-10 diagnosis codes. 
D)  Optical scanning.

Question 20

Match the reason that the insurance claim was rejected with the possible solution to the problem.

-The patient's insurance number is incorrect.

Accepted Answer

A) Proofread numbers carefully from source documents. 
B) Check for Sr., Jr., correct birth date, and verify the insured. 
C) Refer to an updated diagnostic codebook and review the patient record. 
D) Verify with the patient's medical record that all dates of service are listed and accurate. 
E) Verify that the place of service is correct for the submitted procedure code(s) and fill in correct service code.
F)Refer to the current procedure codebooks and verify the coding system used by the insurance company.
G)Verify and submit valid modifiers with the correct procedure codes for which they are valid.
H)Total all charges on each claim, recheck the math, and verify amounts with the patient account.
I)Obtain data from patient during the first office visit on which company is the primary insurer.
J)Submit all attachments with patient's name and insurance identification number. 
A) Proofread numbers carefully from source documents. 
B) Check for Sr., Jr., correct birth date, and verify the insured. 
C) Refer to an updated diagnostic codebook and review the patient record. 
D) Verify with the patient's medical record that all dates of service are listed and accurate. 
E) Verify that the place of service is correct for the submitted procedure code(s) and fill in correct service code.
F)Refer to the current procedure codebooks and verify the coding system used by the insurance company.
G)Verify and submit valid modifiers with the correct procedure codes for which they are valid.
H)Total all charges on each claim, recheck the math, and verify amounts with the patient account.
I)Obtain data from patient during the first office visit on which company is the primary insurer.
J)Submit all attachments with patient's name and insurance identification number.

If the patient will oblige, let the patient direct his or her own insurance form to the insurance company.

OCR guidelines for the CMS-1500 claim form state

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text. -What is the date that the symptoms first presented for the condition treated?

Presently, most health care organizations send the majority of their claims on paper.

Effective ___________, the revised paper claim form (02-12) is required for use by all providers.

To practice medicine within a state, a physician must obtain a physician's state _____.

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text. -What is the procedural code that was submitted on this claim form, describing the services provided to this patient?

Office visits may be grouped on the insurance claim form if each visit

Abstraction of technical information from patient records may be necessary to support medical ___.

List all services on the insurance claim form, including "no charge" services.

Match the reason that the insurance claim was rejected with the possible solution to the problem. -Diagnostic code is missing.

A dirty claim is one that had coffee spilled on it before it was sent to the insurance carrier.

Match the reason that the insurance claim was rejected with the possible solution to the problem. -Patient's name and insured's name are entered as the same when the patient is a dependent.

Match the reason that the insurance claim was rejected with the possible solution to the problem. -Incorrect modifier.

If several services are being billed on the same insurance claim form, you may "ditto" the dates on each line of service below the first line.

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text. -Was the condition related to an auto accident?

An insurance claim form that contains no staples or highlighted areas and on which the bar code area has not been deformed is called

An insurance claim submitted with errors is referred to as

In 2012, the CMS-1500 claim form was revised to version 02-12 to accommodate

Match the reason that the insurance claim was rejected with the possible solution to the problem. -The patient's insurance number is incorrect.

Role of an Insurance Billing Specialist

Compliance, Privacy, Fraud, and Abuse in Insurance Billing

Basics of Health Insurance

Medical Documentation and the Electronic Health Record

Diagnostic Coding

Procedural Coding

The Electronic Claim

Receiving Payments and Insurance Problem Solving

Office and Insurance Collection Strategies

The Blue Plans, Private Insurance, and Managed Care Plans

Medicare

Medicaid and Other State Programs

Tricare and Veterans Health Care

Workers Compensation

Disability Income Insurance and Disability Benefit Programs

Hospital Billing

Seeking a Job and Attaining Professional Advancement

Filters

Exam 7: The Paper Claim: Cms-1500 02-12

If the patient will oblige, let the patient direct his or her own insurance form to the insurance company.

OCR guidelines for the CMS-1500 claim form state

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text. -What is the date that the symptoms first presented for the condition treated?

Presently, most health care organizations send the majority of their claims on paper.

Effective ___________, the revised paper claim form (02-12) is required for use by all providers.

To practice medicine within a state, a physician must obtain a physician's state _____.

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text. -What is the procedural code that was submitted on this claim form, describing the services provided to this patient?

Office visits may be grouped on the insurance claim form if each visit

Abstraction of technical information from patient records may be necessary to support medical ___.

List all services on the insurance claim form, including "no charge" services.

Match the reason that the insurance claim was rejected with the possible solution to the problem. -Diagnostic code is missing.

A dirty claim is one that had coffee spilled on it before it was sent to the insurance carrier.

Match the reason that the insurance claim was rejected with the possible solution to the problem. -Patient's name and insured's name are entered as the same when the patient is a dependent.

Match the reason that the insurance claim was rejected with the possible solution to the problem. -Incorrect modifier.

If several services are being billed on the same insurance claim form, you may "ditto" the dates on each line of service below the first line.

For the following questions, refer to the CMS-1500 claim form illustrated in Figure 7-3 of the text. -Was the condition related to an auto accident?

An insurance claim form that contains no staples or highlighted areas and on which the bar code area has not been deformed is called

An insurance claim submitted with errors is referred to as

In 2012, the CMS-1500 claim form was revised to version 02-12 to accommodate

Match the reason that the insurance claim was rejected with the possible solution to the problem. -The patient's insurance number is incorrect.

Role of an Insurance Billing Specialist

Compliance, Privacy, Fraud, and Abuse in Insurance Billing

Basics of Health Insurance

Medical Documentation and the Electronic Health Record

Diagnostic Coding

Procedural Coding

The Electronic Claim

Receiving Payments and Insurance Problem Solving

Office and Insurance Collection Strategies

The Blue Plans, Private Insurance, and Managed Care Plans

Medicare

Medicaid and Other State Programs

Tricare and Veterans Health Care

Workers Compensation

Disability Income Insurance and Disability Benefit Programs

Hospital Billing

Seeking a Job and Attaining Professional Advancement

Filters