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insurance chapter 7

chapter 7 insurance

QuestionAnswer
who developed the standard form health insurance association of america and american medical association
state the name of the insurance for approved by the american medical association health insurance claim form
does medicare accept the CMS-1500 claim forms yes
what is dual coverage the patient has 2 insurance policies, one of which is considered primary and the other secondary
the insurance company with the first responsibility for payment of a bill for medical services is known as the primary payer
what important document must you have before an insurance company can photocopy a patients chart release of information form signed by patient
if the patient brings in a private insurance form that is not group insurance, where do you send the form after completion to the insurance company
an insurance claim is returned for the reason "diagnosis incomplete." state one or more solutions to this problem on how you would try to obtain reimbursement verify and submit correct diagnostic codes by referring to an updated diagnostic code book and reviewing the patient record
when preparing a claim that is to be optically scanned, birth dates are keyed in with how many digits 8 digits
define this abbreviation: MG/MCD Medigap and medicaid coverage
claim missing required information incomplete claim
phrase used when a claim is held back from payment pending claim
claim that is submitted and then optically scanned by the insurance carrier and converted to electronic form paper claim
claim that needs manual processing because of errors or to solve a problem dirty claim
claim that needs clarification and answers to some questions rejected claim
claim that is cancelled or voided if incorrect claim form is used or itemized charges are not provided delete claim
claim that is submited via telephone line or computer modem electronic claim
claim that is submited within the time limit and correctly completed clean claim
medicare claim that contains information that is complete and necessary but is illogical or incorrect invalid claim
a number issued by the federal government to each individual for personal use social security number
a medicare lifetime provider number national provider identifier
a number listed on a claim when submitting insurance claims to insurance companies under a group name group national provider number
a number that a physician must obtain to practice in a state state license number
a number used for billing for supplies and equipment durable medical equipment number
a number issued to a hospital facility provider number
an invididual physicians federal tax identification number issued by the revenue service employer identification number
a three part information form that is completed and signed by an insurance agent and an individual to obtain insurance coverage, and requires a medical examination by a physician is known as life or health insurance application
the insurance claim form required when submitting medicare claim is CMS-1500 claim form
the maximum number of diagnostic codes in the ANSI 837P claim format for transmitting electronic health insurance claim is eight
if a patients gender is not indicated in the CMS-1500 claim form, the gender block defaults to female
if a provide of medical services does not have an NPI number, the characters or digits that must be entered in block 24I is IC
a photocopy of a claim form may be optically scanned false
handwritting is permitted on optically scanned paper claims false
a CMS-assigned national provider identifier (NPI) number consists of 10 characters true
when listing a diagnostic code on an insurance claim, insert the decimal points false
a diagnosis reference pointer should be entered in block 24E and not an ICD-9-CM diagnostic code true
Created by: Lea99 on 2012-03-06



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