CMS-1500 form Exam Questions And Answers Already Graded A+

(ASCA) The Administrative simplification compliance act - requires that claims to medicare be transmitted electronically, unless clearinghouse is being used by a provider to submit claims a draft may be completed on paper (ASCA) - The Administrative simplification compliance act (NUCC) - National Uniform Claim Committee (NUCC) National Uniform Claim Committee - Organization that maintains the CMS-1500 form any new version would have to be approved by the White House Office Management and Budget(OMB) (OMB) - White House Office Management and Budget Blocks 1-13 - focus on basic information about the patient, and the insured (if diff) also determining which plan is primary and secondary if patient has more than 1 insurance(block 11) Block 1 - Check the box indicating what kind of insurance Block 1a - Patient's Medicare Health insurance claim number (HICN), such as MEDICARE, MEDCAID, TRICARE, CHAMPVA, GROUP HEALTH PLAN, FECA BLK LUNG this number is required whether medicare is primary or secondary Block 2 - the patients' first name, middle initial, and last name as shown on the patient's Medical card Block 3 - Patient's eight digit birth date recorded as MM/DD/CCYY and sex ie: April 04, 1995 would be 04/04/1995Block 4 - If there is insurance primary to medicare, obtained through the patient's or spouse's place of work or through any other source, list the name of the insured here. if the patient and the insured are the same, write SAME. If medicare is primary, leave this field blank. Block 5 - Patient's mailing address and telephone number. mailing address on first line, the city and state on second line, and the zip code and telephone number on the third line. Block 6 - Check the appropriate box for the patient's relationship to the insured, self, spouse, child, other Block 7 - Enter the insured's address and telephone number . If the insured is the same as the patient write, SAME. complete this block only after 4, 6, and 11 have been completed.