Review
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| show | claim attachment
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| show | encounter form
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| The primary objective in submitting claims is to submit | show 🗑
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| The patient/insured section of the CMS-1500 includes blocks _____________ through ____________ | show 🗑
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| show | diagnostic code
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| Identify an important advantage of filing claims electronically reduce | show 🗑
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| show | findings
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| The document on which patients’ charges and payments are recorded is the_ | show 🗑
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| The source for patient information, such as name of insurer, policy number, copayment, and/or name of primary care physician, can be found on | show 🗑
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| An example of a correctly reported birth date in block 3 of the CMS-1500 is | show 🗑
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| One of the health insurance professional’s most important responsibilities is maximizing | show 🗑
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| Submitting insurance claims directly to a third-party payer is called | show 🗑
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| The two main sections of the CMS-1500 are | show 🗑
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| A claim that has no errors, omissions, and can be processed without delays is called a | show 🗑
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| show | physician/supplier info
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| show | NPI
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| The 9-digit federal tax identification number is commonly referred to as the | show 🗑
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| show | pt info, insurance card, and health record
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| The front side of the CMS-1500 is printed in 33 block | show 🗑
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| Medicare claims must be submitted electronically, unless the HHS Secretary grants a | show 🗑
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| show | top
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| Specific guidelines for OCR scan able claims include | show 🗑
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| show | ASCII
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| OCR works best with original copies using | show 🗑
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| Members of a PPO normally do not have to choose a | show 🗑
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| A system designed to determine the medical necessity and appropriateness of a requested medical service or procedure is a | show 🗑
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| show | staff model
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| A specific provider who oversees the entire care and treatment of a patient in an HMO is called a | show 🗑
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| The formal term for a written complaint submitted by an individual covered by a special plan or policy is called a | show 🗑
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| show | explanation of benefits
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| show | utilization review
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| show | PPO
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| Today, the “Blue System” is the largest single processor of Medicare claims, which is called a | show 🗑
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| Individuals who are members of a managed care plan are commonly referred to as | show 🗑
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| The plan types within managed care plans include what 3 types of insurance | show 🗑
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| A health care provider trained in a specific medical specialty is a | show 🗑
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| Many Americans obtain health insurance owing to their employment through what is commonly referred to as | show 🗑
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| A private, nonprofit organization that accredits health care plans based on evaluation of the quality of care given to plan members is the | show 🗑
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| With many MCOs, the enrollee typically pays a small fee upfront when visiting his or her PCP called a | show 🗑
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| A request by a health care provider for his or her patient to be evaluated or treated by a specialist is a | show 🗑
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| show | consultation
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| show | self insurance
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| Policy premiums, yearly deductible, and coinsurance are the three out-of-pocket costs in | show 🗑
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| What organizations is responsible for creating the revised CMS-1500 | show 🗑
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| show | IPA
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| show | ERSA's/ASO's
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| show | indeminty/managed care
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| show | NCQA
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| Many FFS policies set a limit for what they will reimburse their members for any charges incurred, which is referred to as a life time | show 🗑
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| show | timely filing
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