- Study guides, Class notes & Summaries

Chapter 11: CMS-1500 and UB-04 Claims questions with verified answers

-

10 pages

Written in 2024/2025

Grade A+

7Eleven

CMS-1500 Health Insurance Claim Form Exam Questions and Answers Already Passed HCFA stands for : - Answers Health Care Financing Administration The HCFA-1500 paper health insurance form was developed in______ by ________________ : - Answers 1975; Health Care Financing Administration (HCFA) The HCFA claim form was developed to be used by providers for what purpose? - Answers Billing Medicare for outpatient services HCFA changed its name to what in July of 2001? - Answers Center for Medicare ...

-

6 pages

Written in 2025/2026

Grade A+

joshuawesonga22

CMS 1500, | UPDATED Questions with 100% Correct Answers

-

8 pages

Written in 2026/2027

Grade A+

ExamsCollection

Cms -1500 Exam Questions Answered Correctly Latest Update 2026 On Cms-1500 Where Does The Patient Information Go? - Answers On The Top Of The Form What Innovation Simplified Insurance Claim Submissions? - Answers Cms-1500 Most Common Format Used For Computer Text Files And Internet? - Answers Ascii Ocr Works Best With Original Copies Using What? - Answers Mono-Spaced Fonts Specific Guidelines For Ocr Scan Claims Do Not Include What? - Answers Inserting Correct Punctuation Documents ...

-

1 pages

Written in 2025/2026

Grade A+

TutorJosh

Cms-1500 | The Smart Way To Pass | Real Tests, Real Results!

-

12 pages

Written in 2025/2026

Grade A+

Apphia

CMS 1500 Claim Form Exam Questions and Answers Latest Update 2025/2026 The top portion of the claim form where the insurance company address is entered - Answers Upper margin Where the insurance type is marked with an X - Answers Block 1 Qualifier for DOA/Date of present illness block 14 - Answers 431 Qualifier for LMP block 14 - Answers 484 Referring Provider block 17 - Answers DK Ordering provider block 17 - Answers DQ Supervising provider block 17 - Answers DK They are arranged in 8 d...

-

4 pages

Written in 2025/2026

Grade A+

joshuawesonga22

Form Locator 1: Type of Insurance AnsIdentifies what type of insurance the patient carries. List of governmental plans: Medicare, Medicaid, TRICARE/CHAMPUS, CHAMPVA, and FECA Black Lung. 2 other options: Group Health Plan and other. Form Locator 1a: Insured's I.D. Number AnsAsks for the insured's insurance I.D. Number as reflected on the insurance card. Form Locator 2: Patient's name AnsEnter the name of the patient who received services. This information is inpu...

-

14 pages

Written in 2025/2026

Grade A+

cracker

Digital files that are not printed on claim forms when submitted to the payers - The ASCA was enacted by Congress to improve administration of the Medicare program by increasing efficiencies gained through these submissions. Anselectronic claims The ________ provides an exception to the Medicare electronic claims submission requirements to small health care organizations AnsASCA Despite the transition to electronic claims submission, the paper claim continues to be an impor...

-

10 pages

Written in 2025/2026

Grade A+

cracker

CMS-1500 Ansused to request payment from health insurance payers, like Medicare, after a patient has been treated. To fill out the form you must have: -the patient registration form -patient health record documentation -superbill/encounter form patient registration form Anscontains the patient's demographic information and health insurance payer information. This information must be up to date, and most practices will institute a policy of verifying the information upon each vi...

-

15 pages

Written in 2025/2026

Grade A+

cracker

Types of microscopes Ans1. dissecting- looks at overall structure of an organism 2. compound- for organisms organelles, cells, etc. 3. inverted- looks at bacterium Know the parts of the microscope Ans At 100x we must always Ansuse oil immersion Total magnification= Ansocular lens (10x) x objective lens microscope image always appears Ansupside down and reversed (inverted) How do you move the specimen on the microscope? AnsALWAYS move the slide in the opposite d...

-

11 pages

Written in 2025/2026

Grade A+

cracker

_________ means the patient has authorized the payment of benefits directly to the provider AnsAssignment of benefits Which of the following is not included in the insurance carrier's role ? AnsCollect a copayment from the physician The date in block 14 is the date Ansonset of illness A Superbill/encounter form provides which of the following? AnsProcedures and charges The federal tax ID number (box 25) for the provider filing the claim can be presented as AnsSSN a...

-

5 pages

Written in 2025/2026

Grade A+

cracker

HCFA stands for : AnsHealth Care Financing Administration The HCFA-1500 paper health insurance form was developed in______ by ________________ : Ans1975; Health Care Financing Administration (HCFA) The HCFA claim form was developed to be used by providers for what purpose? AnsBilling Medicare for outpatient services HCFA changed its name to what in July of 2001? AnsCenter for Medicare and Medicaid Services (CMS) HCFA-1500 claim form was changed to this in July of 2001...

-

11 pages

Written in 2025/2026

Grade A+

cracker

When reporting line item services on multiple page CMS-1500 claims, which statement is TRUE? a. The listed diagnosis can change from page to page. b. Only the diagnosis code(s) reported on the first page may be used and must be repeated on subsequent pages. c. More than 12 diagnoses can be reported on a two-page claim. d. Services related to the additional diagnoses can be on the same claim Ansb. Only the diagnosis code(s) reported on the first page may be used and must be repea...

-

14 pages

Written in 2025/2026

Grade A+

cracker

What three items do you need in order to fill out the CMS 1500? AnsPatients registration form, patient's health record Documentation, superbill/encounter form. What is a paper claim? AnsAny form that is submitted to the third party payer on paper, whether or not it is tight or completed on a computer and print it on the computers printer. What is a pica? AnsA measurement of text that is used in design and print. CMS 1500 has three boxes in both the upper left and upper ri...

-

10 pages

Written in 2025/2026

Grade A+

cracker

VERIFICATION OF ELIGIBILITY Ans- The process of contacting a patient's insurance company prior to any encounter to determine patient benefits and responsibilities for services. SIGNATURES Ans• Patient and Provider "signatures" are required on all CMS-1500 claim forms, whether in paper or electronic form. However, handwritten signatures are not required on the form itself (or electronically), therefore indicating Signature on File (SOF) is acceptable. • Patient s...

-

19 pages

Written in 2025/2026

Grade A+

cracker

Hospital room and board AnsThe 1500 form is used to bill for all of the items below EXCEPT: Select one: a. lab work performed in any outpatient setting b. x-rays done in a physician's office c. doctors' office visits d. surgery done at an Ambulatory Surgical Center e. hospital room and board False AnsTrue or False: For Non-Medicare claims, the 1500 claim form should be completed in all capital letters C AnsFor a Non-Medicare claim, Items 17 and 17b on a 1500 cla...

-

7 pages

Written in 2025/2026

Grade A+

cracker

Instructions: Review the following unrelated scenarios and enter the data into the fields for A, D, F, and G of Block 24 of the CMS-1500. If a procedure is performed on consecutive dates, enter them on one line. Please be aware that when an answer consists of more than one code, there will be an answer blank for each code. Entering Procedures in Block 24: 10/10/YYYY, OV, est pt, detailed history and physical exam, 99214, $65.00 Block 24A (From) MM _____ Block 24A (From) DD ...

-

15 pages

Written in 2025/2026

Grade A+

cracker

The American Medical Association and the Center for Medicare and Medicaid services (CMS) AnsWho teamed up to make a uniform claim document, the CMS-1500, nearly all providers use NUCC AnsNational Uniform Claim Committee National Uniform Claim Committee (NUCC) Ansorganization responsible for claim content and approval Being precise and consistent AnsWhat needs to be done so that a claim form will not lead to rejection 837P AnsThe electronic version of the CMS 1500 pape...

-

11 pages

Written in 2025/2026

Grade A+

cracker

A paper claim that does not have any staples or highlighted areas and on which the bar code area has not been deformed is referred to as a Ansphysically clean claim. Office visits may be grouped on the insurance claim form if each visit is consecutive and uses the same procedure code. is consecutive, uses the same procedure code, and results in the same fee. uses the same diagnosis code. occurs during the same month. Ansis consecutive, uses the same procedure code, and re...

-

5 pages

Written in 2025/2026

Grade A+

cracker

The white Carrier Block area Ansthe name and address of the payer to whom the claim is being sent. Block number 1 AnsIndicate the type of health insurance-coverage applicable to this claim by placing an X in the appropriate box. Block Number 1 a Ans" Insured's ID Number" is the identification number of the insured and identifies the insured to the payer. Block number 2 AnsPatient's Name ;enter patients full name and any suffix. The "Patient's Name" is ...

-

9 pages

Written in 2025/2026

Grade A+

cracker

NUCC AnsOrganization that determines the content of CMS-1500 claim form UB-04 AnsIt is used for inpatient services and procedures 837 claim AnsHIPAA-mandated electronic transaction standard for claims Adjudication AnsProcess health plans follow to examine claims and determine payment (OCR) Optical Character Reader guideline AnsUse uppercase alpha characters Medical Necessity AnsIt is the significance of linking diagnosis and procedures codes on claims

-

7 pages

Written in 2025/2026

Grade A+

cracker