Health Insurance and Claims Chapter 11- 13
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| The legal business name of the practice is called what? | show 🗑
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| show | Medigap
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| What occurs when a physician in the community refers a patient to the hospital for observation, bypassing the clinic or emergency department (ED). | show 🗑
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| One charge covers presurgical evaluation and management, initial and subsequent hospital visits, surgical procedure, the discahrg visit, and uncomplicated postop follow-up care in the surgeon's office. | show 🗑
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| show | supplemental plan
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| show | observation care
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| show | They are billed as an additional procedure.
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| show | When you submit a typewritte claim you must use one of those font types.
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| Are you allowed to submit a photocopy of a CMS-1500 claim form? | show 🗑
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| show | No, they should be placed on an attachment to the claim.
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| show | It is a unique 10-digit number issued to individual providers.
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| Is submission of an NPI required on a CMS-1500 claim to large or small health plans? | show 🗑
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| What is assignment of benefits? | show 🗑
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| show | It is when the provider agrees to accept as payment in full whatever the payer reimburses.
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| If the payer accepts assignment it the patient still responsible for their deductible, copayment, and/or coinsruance? | show 🗑
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| What is the maximum number of ICD-9 CM codes that you can put on a CMS-1500 claim? | show 🗑
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| show | 6
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| The first-listed code reported should be what? | show 🗑
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| show | Yes, you should enter the code with the highest fee in line 1 of Block 24, and then enter additional codes in descending order of charges.
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| EIN | show 🗑
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| show | Incident to
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| Can outpatient observation care for a Medicare patient progress to an inpatient admission? | show 🗑
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| Can an inpatient admission for a Medicare patient converted to outpatient observation care? | show 🗑
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| What are the three ways to document that a patient has authorized the release of any medical or other information necessary to process their claim in Block 12 of the CMS-1500 claim? | show 🗑
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| show | BlueCard program
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| What BCBS plan is an employer-sponsored health plan program for federal employees? | show 🗑
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| What is another name for the Federal Employee Health Benefits Program? | show 🗑
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