Question 1

What type of signature should be used in Item Number 31?

Accepted Answer

A)   legal signature of the practitioner
B)   signature of the practitioner representative
C)   SOF
D)   all of theseE) All of the above
F) A) and B)

Question 2

The insured's ID number is the

Accepted Answer

A)   payer's identification number.
B)   physician's NPI.
C)   physician's legacy number.
D)   identification number of the policy holder.E) None of the above
F) A) and C)

Question 3

You are reporting an unlisted procedure code that requires a very lengthy narrative description. Determine the best way to present this information to the payer.

Accepted Answer

A)   Provide a special report.
B)   Write a description in the margin of the CMS-1500 claim form.
C)   Wait until information is requested from the payer.
D)   Write part of the description in Item Number 19 as space allows.E) A) and B)
F) All of the above

Question 4

A payer requires the provider to list specific identifiers supplemental claim information on the CMS-1500. Determine the most likely place they would require this information to be reported.

Accepted Answer

A)   Item Number 19
B)   Item Number 24
C)   Item Number 20
D)   Item Number 22E) B) and C)
F) A) and B)

Question 5

What entity is the destination payer?

Accepted Answer

A)   the patient who is receiving a payment from a health plan
B)   the health plan receiving a HIPAA claim
C)   the provider that is receiving a payment from a health plan
D)   the provider who is seeing the patientE) A) and C)
F) A) and B)

Question 6

Identify the claim filing indicator code that is used to indicate a self-pay patient.

Accepted Answer

A)   12
B)   10
C)   09
D)   11E) B) and C)
F) None of the above

Question 7

What information might be recorded in Item Number 25?

Accepted Answer

A)   the physician's or supplier's EIN or SSN
B)   the legacy number
C)   the physician's NPI number
D)   the referring physician's NPI numberE) A) and B)
F) All of the above

Question 8

When nonspecific procedure codes such as unlisted CPT codes are used, the claim must contain

Accepted Answer

A)   extra diagnosis codes.
B)   HCPCS codes.
C)   modifiers.
D)   service-line level description of the work or drug/dosage.E) All of the above
F) A) and D)

Question 9

A billing service sending a claim is likely to be the

Accepted Answer

A)   referring provider.
B)   destination payer.
C)   pay-to provider.
D)   billing provider.E) A) and C)
F) All of the above

Question 10

How many different types of providers may need to be identified?

Accepted Answer

A)   five
B)   three
C)   four
D)   twoE) A) and D)
F) B) and D)

Question 11

You are completing a CMS-1500 and realize that a husband has additional coverage under his wife's policy. Determine where you would record the wife's name on the CMS-1500 for the additional insurance.

Accepted Answer

A)   Item Numbers 10a-10c
B)   Item Number 8
C)   Item Number 11d
D)   Item Number 9E) B) and D)
F) A) and B)

Question 12

Determine what was not required of PMP vendors when the HIPAA 837 electronic transaction was mandated.

Accepted Answer

A)   receiving certification from HIPAA testing vendors that their software can accommodate HIPAA-mandated transactions
B)   providing updates at no additional cost
C)   maintaining up-to-date software products
D)   training office personnel in the use of new featuresE) All of the above
F) C) and D)

Exam 7: Health Care Claim Preparation and Transmission

A payer requires the provider to list specific identifiers supplemental claim information on the CMS-1500. Determine the most likely place they would require this information to be reported.

Correct Answer
verified

You are reporting an unlisted procedure code that requires a very lengthy narrative description. Determine the best way to present this information to the payer.

Correct Answer
verified

When nonspecific procedure codes such as unlisted CPT codes are used, the claim must contain

Correct Answer
verified

The insured's ID number is the

Correct Answer
verified

How many different types of providers may need to be identified?

Correct Answer
verified

A billing service sending a claim is likely to be the

Correct Answer
verified

Determine what was not required of PMP vendors when the HIPAA 837 electronic transaction was mandated.

Correct Answer
verified

What type of signature should be used in Item Number 31?

Correct Answer
verified

What information might be recorded in Item Number 25?

Correct Answer
verified

What entity is the destination payer?

Correct Answer
verified

Identify the claim filing indicator code that is used to indicate a self-pay patient.

Correct Answer
verified

You are completing a CMS-1500 and realize that a husband has additional coverage under his wife's policy. Determine where you would record the wife's name on the CMS-1500 for the additional insurance.

Correct Answer
verified

Exam 7: Health Care Claim Preparation and Transmission

A payer requires the provider to list specific identifiers supplemental claim information on the CMS-1500. Determine the most likely place they would require this information to be reported.

Correct AnswerverifiedShow Answer

You are reporting an unlisted procedure code that requires a very lengthy narrative description. Determine the best way to present this information to the payer.

Correct AnswerverifiedShow Answer

When nonspecific procedure codes such as unlisted CPT codes are used, the claim must contain

Correct AnswerverifiedShow Answer

The insured's ID number is the

Correct AnswerverifiedShow Answer

How many different types of providers may need to be identified?

Correct AnswerverifiedShow Answer

A billing service sending a claim is likely to be the

Correct AnswerverifiedShow Answer

Determine what was not required of PMP vendors when the HIPAA 837 electronic transaction was mandated.

Correct AnswerverifiedShow Answer

What type of signature should be used in Item Number 31?

Correct AnswerverifiedShow Answer

What information might be recorded in Item Number 25?

Correct AnswerverifiedShow Answer

What entity is the destination payer?

Correct AnswerverifiedShow Answer

Identify the claim filing indicator code that is used to indicate a self-pay patient.

Correct AnswerverifiedShow Answer

You are completing a CMS-1500 and realize that a husband has additional coverage under his wife's policy. Determine where you would record the wife's name on the CMS-1500 for the additional insurance.

Correct AnswerverifiedShow Answer

Correct Answer
verified

Correct Answer
verified

Correct Answer
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Correct Answer
verified

Correct Answer
verified

Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
verified

Correct Answer
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