medical reimbursement test 2 hadm

Know about assignment of benefits correct answer: signature on file correct answer: Define paper claim correct answer: an insurance claim submitted on paper, including those optically scanned and converted to an electronic form by the insurance carrier. Incomplete claim correct answer: any Medicare claim missing necessary information; such claims are identified to the provider so that they may be resubmitted. Pending claim correct answer: an insurance claim held in suspense because of review or other reason. These claims my be cleared for payment or denied. Rejected claim correct answer: an insurance claim submitted to an insurance carrier that is discarded by the system because of technical error(omission or erroneous information) or because it does not follow Medicare instructions. It is returned to the provider for correction or change so that it may be processed properly for payment. Electronic claim correct answer: an insurance claim submitted to the insurance carrier via a central processing unit (CPU) tape, diskette, direct data entry, direct wire, dial-in telephone, digital fax, or personal computer download or upload. Dirty claim correct answer: a claim submitted with errors or one that requires manual processing to resolve problems or rejected for payment. Invalid claim correct answer: any Medicare claim that contains complete, necessary information but is illogical or incorrect (for example, listing an incorrect provider number for a referring physician). Invalid claims are identified to the provider and may be resubmitted. Know what a universal claim form is. correct answer: CMS-1500, developed by the National Uniform Claim Committee (NUCC). Originally called Health Insurance Claim Form (HCFA-1500) Is the form required when submitting Medicare claims and is accepted by nearly all state Medicaid programs and private third party payer as well as TRICARE and worker's compensation Know what info to send for a medical record request correct answer: To complete insurance claim forms When sending a letter to justify a health insurance claim after professional services are rendered When a patient applies for life, mortgage, or health insurance be able to list if the insurance claim would be rejected. What would be the solution to the problem? matching correct answer: