Page |1
HIT235- Module 3 EHR Go Activities
Questions and Correct Answers/ Latest
Update / Already Graded
Provider Name and Address (FL. 1)
Ans: Required - Properly completed on sample form
Service Date (FL. 45)
Ans: Required - Not properly completed on sample form
Statement Covers Period (FL. 6)
Ans: Required - Properly completed on sample form
Source of Admission (FL. 15)
Ans: Required - Not properly completed on sample form
Payer Name (FL. 50A)
Ans: Required - Properly completed on sample form
Admit diagnosis (FL. 69)
All rights reserved © 2025/ 2026 |
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Ans: Required - Not properly completed on sample form
Other Operating Physician Name/NPI (FL. 79)
(Secondary surgeon or Assisting surgeon)
Ans: Situational - not appropriate to this claim
Release of Information Certification (FL. 52)
Ans: Required - Not properly completed on sample form
Patient Control Number (FL. 3a)
Ans: Required - Not properly completed on sample form
Type of Admission/Visit (FL. 14)
Ans: Required - Properly completed on sample form
Insured's Unique ID (FL. 60A)
Ans: Required - Properly completed on sample form
Code-Code Field (FL. 81)
All rights reserved © 2025/ 2026 |
HIT235- Module 3 EHR Go Activities
Questions and Correct Answers/ Latest
Update / Already Graded
Provider Name and Address (FL. 1)
Ans: Required - Properly completed on sample form
Service Date (FL. 45)
Ans: Required - Not properly completed on sample form
Statement Covers Period (FL. 6)
Ans: Required - Properly completed on sample form
Source of Admission (FL. 15)
Ans: Required - Not properly completed on sample form
Payer Name (FL. 50A)
Ans: Required - Properly completed on sample form
Admit diagnosis (FL. 69)
All rights reserved © 2025/ 2026 |
, Page |2
Ans: Required - Not properly completed on sample form
Other Operating Physician Name/NPI (FL. 79)
(Secondary surgeon or Assisting surgeon)
Ans: Situational - not appropriate to this claim
Release of Information Certification (FL. 52)
Ans: Required - Not properly completed on sample form
Patient Control Number (FL. 3a)
Ans: Required - Not properly completed on sample form
Type of Admission/Visit (FL. 14)
Ans: Required - Properly completed on sample form
Insured's Unique ID (FL. 60A)
Ans: Required - Properly completed on sample form
Code-Code Field (FL. 81)
All rights reserved © 2025/ 2026 |