Which of the following pieces of information is required on the CMS-1500 claim form?
The date the patient's illness ended
The patient's filing limits
The patient's previous account balance
The patient's insurance identification number
The Correct Answer is D
A. The date the patient's illness ended: The form does not require the end date of the patient’s illness, but the date of service and diagnosis are needed.
B. The patient's filing limits: Filing limits are set by the insurance carrier and are not required information on the CMS-1500 form.
C. The patient's previous account balance: The previous account balance is not required on the claim form; this form is for billing current services.
D. The patient's insurance identification number: The patient's insurance identification number is required to process the claim with the correct insurance provider.
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Related Questions
Correct Answer is A
Explanation
A. Choose procedure codes based on the encounter form. The encounter form, also known as a superbill, lists the procedures and services provided during the visit. The correct procedure codes (CPT codes) should be selected from this form to ensure accurate billing.
B. Upcode for greater reimbursement. Upcoding, or selecting a higher-level code than justified, is illegal and unethical as it constitutes fraud. This should never be done.
C. Refer to ICD-9 for diagnostic codes. ICD-9 codes have been replaced by ICD-10 codes, which are now the standard for diagnostic coding in the United States. Referring to ICD-9 codes would result in incorrect or outdated billing.
D. Enter all data using lowercase letters. Data entry in all lowercase letters is not a standard practice in medical billing and would not affect the accuracy of the codes. Proper case usage is typically recommended for clarity.
Correct Answer is A
Explanation
A. Speak in a neutral tone: Using a neutral tone helps de-escalate the situation and shows that you are calm and professional, which can help soothe an angry patient.
B. Speak louder than the patient: Speaking louder can escalate the situation further and increase the patient’s frustration.
C. Disregard the patient's mood: Disregarding the patient’s mood can make them feel ignored and may worsen their anger.
D. Ask the patient to reschedule: Asking the patient to reschedule may be appropriate in some cases but does not address the immediate issue of handling their anger effectively.
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