Review
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| When an unlisted procedure code is reported you must attach the | show 🗑
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| show | encounter form
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| show | clean claim
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| The patient/insured section of the CMS-1500 includes blocks _____________ through ____________ | show 🗑
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| A common cause for insurance claims to be rejected is invalid patient | show 🗑
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| Identify an important advantage of filing claims electronically reduce | show 🗑
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| show | findings
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| show | ledger card
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| show | insurance identification card
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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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| show | reimbursment
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| Submitting insurance claims directly to a third-party payer is called | show 🗑
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| show | pt/supplier
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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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| The bottom half of the CMS-1500 form is used for | show 🗑
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| The main reason for revising the CMS-1500 form is for HIPAA mandated | show 🗑
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| The 9-digit federal tax identification number is commonly referred to as the | show 🗑
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| Documents needed to complete a paper CMS-1500 include | show 🗑
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| The front side of the CMS-1500 is printed in 33 block | show 🗑
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| show | waiver
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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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| show | primary care
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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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| To reduce unnecessary inpatient/outpatient services, managed care plans use | show 🗑
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| A group of health care providers working under one umbrella to provide medical services at a discount to the individuals who participate in the plan is referred to as a | show 🗑
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| show | fiscal intermediary
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| Individuals who are members of a managed care plan are commonly referred to as | show 🗑
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| show | POS, HMO, PPO
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| show | specialist
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| show | group insurance
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| show | NCQA
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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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| show | referral
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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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| show | NUCC/NUBC
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| A type of HMO whereby services are provided by outpatient networks composed of individual health care providers who supply all necessary patient care is a | show 🗑
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| show | ERSA's/ASO's
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| show | indeminty/managed care
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| The private, not-for-profit organization dedicated to improving health care quality and frequently referred to as the managed care “watch dog” is | show 🗑
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| show | insurance cap
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| show | timely filing
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