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Healthcare claim preparation and transmission

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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Question
Answer
The HIPAA mandated electronic transaction for claims is known as the HIPAA claim, the 837 claim, and the   show
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What organization determines the content of both the HIPAA 837 and the CMS 1500 claims?   show
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show upper right  
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show they type of insurance, patient's relationship to the insured, authorized person's signature.  
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A billing service that is sending a claim is likely to be the   show
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show pay-to-provider  
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show rendering provider  
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show physician is the pay-to and the laboratory is the rendering.  
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The rendering provider is the   show
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show qualifier  
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show procedures performed for the patient  
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show required data element  
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show situational data element  
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show individual relationship code  
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An individual relationship code indicates what   show
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ON a HIPAA claim, a claim control number and the line item control number can be assigned to the claim by whom   show
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show National Payer ID  
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show valid at the time the service was provided  
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show valid at the time the claim was prepared  
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show additional data sent to support a claim  
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show clean claims  
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show three  
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show direct transmission to the payer  
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show National Provider Identifier  
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show NPI  
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show National Uniform Claim Committee  
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Who mandates the use of the NPI on claims   show
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show report physicians' services  
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Who mandates HIPAA claims from most providers   show
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show The National Uniform Claim Committee  
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What type of claims are usually created using a patient billing program, printed and then mailed to the payer?   show
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show the patient  
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show eight  
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The referring provider is the physician who   show
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show Place of service  
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show administrative codes set for identifying a physician's specialty  
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A taxonomy code consists of   show
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show off the premises of the ordering physician.  
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A non-NPI ID number has 2 parts, these parts are   show
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show which procedure code and which diagnosis codes are connected to that date of service  
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show Professional  
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show assumes the payment of the patient's bill  
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The term subscriber also means   show
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show 5  
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What are the 5 major sections of a HIPAA claim   show
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show A claim frequency code  
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show the biller  
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show claim scrubber  
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show clearinghouse  
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the person or organization that will be paid for the services on a HIPAA claim   show
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show billing provider  
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Created by: monicagunterman