HCMA 115 Questions and Answers for Chapter 15 & 16

The primary insurance policy information is contained in block - 11 If the ICD-10-CM codes and the CPT/HCPCS codes do not match the claim will not show - medical necessity Procedure code modifiers are found in column __________ of block 24. - D The physician's signature is located in block - 31 Claims that are done by direct billing first go to a clearinghouse. - False The medical assistant should __________ the front and back of the patient's insurance card - Copy Secondary insurance policy information is contained in block - 9 After the deductible has been met the policyholder is responsible for a certain percentage of the bill is the definition of: - co-insruance The abbreviation often used in blocks 12, 13, and 31 is - SOF The National Provider Identifier is assigned by the AMA. - False A claim that is missing information and is returned to the provider for correction and resubmission is called a(n) __________ claim - incomplete Electronic claims are submitted via the internet. - True The insured's address in block 7 refers to the __________ address - policyholder's How many diagnoses can be reported on the CMS-1500 - twelve A secondary health plan is noted in which block - 11d A PAR provider can bill the patient for the difference between their fee and insurance companies allowed amount - false The federal tax identification number is found in block - 25 The provider is paid a set amount for each enrolled person assigned to them, per period of time, whether or not that person has received services is the definition of: - capitation. When completing the CMS-1500 form, which section contains information about the patient and the insured? - Section 2