Question 1

Block 33 of the CMS-1500 claim requires entry of the name, address, and telephone number of the billing entity, which is the __________.

Accepted Answer

A)   last name of the provider who applied for an EIN
B)   legal business name of the practice
C)   name of the provider who started the practice
D)   provider who treats the most patientsE) A) and B)
F) A) and C)

Question 2

The MUE project was implemented by CMS as part of the NCCI to improve the accuracy of Medicare payments by __________.

Accepted Answer

A)   comparing units of service with payment requested on submitted claims
B)   detecting and denying unlikely Medicare claims on a prepayment basis
C)   reimbursing submitted claims within 30 days of receipt and adjudication
D)   reporting errors due to inappropriate units of service, reducing overpaymentsE) All of the above
F) A) and B)

Question 3

Surgeon's charges for inpatient and outpatient surgery are billed according to a global fee, which means that __________ cover(s)  presurgical evaluation and management, initial and subsequent hospital visits, surgical procedure, the discharge visit, and uncomplicated postoperative follow-up care in the surgeon's office.

Accepted Answer

A)   multiple charges
B)   one charge
C)   separate charges
D)   unit-based chargesE) C) and D)
F) A) and B)

Question 4

When the YES box in Block 27 of the CMS-1500 claims contains an X, the provider agrees to receive as payment in full whatever the payer reimburses. This concept is called __________.

Accepted Answer

A)   accept assignment
B)   assignment of benefitsC) A) and B)
D) undefined

Question 5

Which is a licensed physician in good standing who, according to state regulations, engages in the direct management of nonphysician practitioners whose duties are encompassed by that physician's scope of practice?

Accepted Answer

A)   attending physician
B)   managing physician
C)   primary care physician
D)   supervising physicianE) C) and D)
F) All of the above

Question 6

Supplemental plans usually cover the deductible and copay or coinsurance of a primary health insurance policy. Which is the best known supplemental plan?

Accepted Answer

A)   Medicaid
B)   Medigap
C)   Medicare
D)   TRICAREE) A) and B)
F) None of the above

Question 7

Patients sign Block 13 of the CMS-1500 claim to instruct the payer to directly reimburse the provider. This concept is called __________.

Accepted Answer

A)   accept assignment
B)   assignment of benefitsC) A) and B)
D) undefined

Exam 11: Essential Cms-1500 Claim Instructions

Supplemental plans usually cover the deductible and copay or coinsurance of a primary health insurance policy. Which is the best known supplemental plan?

Correct Answer
verified

Correct Answer
verified

Which is a licensed physician in good standing who, according to state regulations, engages in the direct management of nonphysician practitioners whose duties are encompassed by that physician's scope of practice?

Correct Answer
verified

When the YES box in Block 27 of the CMS-1500 claims contains an X, the provider agrees to receive as payment in full whatever the payer reimburses. This concept is called __________.

Correct Answer
verified

Block 33 of the CMS-1500 claim requires entry of the name, address, and telephone number of the billing entity, which is the __________.

Correct Answer
verified

Patients sign Block 13 of the CMS-1500 claim to instruct the payer to directly reimburse the provider. This concept is called __________.

Correct Answer
verified

The MUE project was implemented by CMS as part of the NCCI to improve the accuracy of Medicare payments by __________.

Correct Answer
verified

Exam 11: Essential Cms-1500 Claim Instructions

Supplemental plans usually cover the deductible and copay or coinsurance of a primary health insurance policy. Which is the best known supplemental plan?

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

Which is a licensed physician in good standing who, according to state regulations, engages in the direct management of nonphysician practitioners whose duties are encompassed by that physician's scope of practice?

Correct AnswerverifiedShow Answer

When the YES box in Block 27 of the CMS-1500 claims contains an X, the provider agrees to receive as payment in full whatever the payer reimburses. This concept is called __________.

Correct AnswerverifiedShow Answer

Block 33 of the CMS-1500 claim requires entry of the name, address, and telephone number of the billing entity, which is the __________.

Correct AnswerverifiedShow Answer

Patients sign Block 13 of the CMS-1500 claim to instruct the payer to directly reimburse the provider. This concept is called __________.

Correct AnswerverifiedShow Answer

The MUE project was implemented by CMS as part of the NCCI to improve the accuracy of Medicare payments by __________.

Correct AnswerverifiedShow Answer

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified