Health Insurance and Claims Chapter 11- 13
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| The legal business name of the practice is called what? | show 🗑
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| show | Medigap
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| show | direct admission
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| show | global fee/global surgery package
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| What is a secondary insurance plan called? It usually covers the deductible and copay or coinsurance of the primary health insurance policy. | show 🗑
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| a well-defined set of specific, clinically appropriate services, which include ongoing short-term treatment, assessment, and reassessment before a decision can be made regarding whether patients will require further tx as hosp inpatients or be discharged. | show 🗑
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| Are postoperative complications requiring a returnt ot he operating room for surgery related to the original procedure billed as an additional procedure or are they part of the global surgery package? | show 🗑
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| What are pica type, Courier 10 or OCR10? | show 🗑
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| Are you allowed to submit a photocopy of a CMS-1500 claim form? | show 🗑
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| Should handwritten notes, printed material, or special stamps be on a CMS-1500 form? | show 🗑
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| show | It is a unique 10-digit number issued to individual providers.
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| show | It was required for both, effective May 23, 2008
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| What is assignment of benefits? | show 🗑
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| show | It is when the provider agrees to accept as payment in full whatever the payer reimburses.
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| If the payer accepts assignment it the patient still responsible for their deductible, copayment, and/or coinsruance? | show 🗑
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| What is the maximum number of ICD-9 CM codes that you can put on a CMS-1500 claim? | show 🗑
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| What is the maximum number of CPT and/or HCPCS codes that you can put on a CMS-1500 claim? | show 🗑
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| The first-listed code reported should be what? | show 🗑
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| show | Yes, you should enter the code with the highest fee in line 1 of Block 24, and then enter additional codes in descending order of charges.
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| EIN | show 🗑
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| What is it called if a nonphysician practitioner in a group practice bills under their supervising physician? | show 🗑
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| show | Yes
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| show | No
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| show | 1. They can sign the form in Block 122. The Billing Specialist can type SIGNATURE ON FILE in Block 12.3. The Billing Specialist can type SOF in Block 12.
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| What BCBS program enables is members to obtain healthcare services while traveling or living in another BCBS Plan's service area to receive the benefits of their home Plan contract and to access local provider networks? | show 🗑
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| show | Federal Employee Health Benefits Program (FEHBP)
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| show | Federal Employee Program (FEP)
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