question

Presently, most health care organizations send the majority of their claims on paper

answer

False

question

It is not important for the health insurance specialist to understand how to complete a paper claim

answer

False

question

The AMA was named in the administrative simplification of the HIPAA of 1996 as the authoritative voice regarding national standard content for submission of claims

answer

False

question

A photocopy of the CMS 1500 claim form is acceptable if the form is processed by the insurance carrier through scanning equipment

answer

False

question

A paper claim is one that is submitted on paper, then optically scanned and converted to electronic form by insurance companies

answer

True

question

A physically clean claim is one that has all of the necessary information required reported on it

answer

False

question

A dirty claim is one that had coffee spilled on it before sending to the insurance carrier

answer

False

question

The CMS-1500 is known as the

answer

basic paper claim

question

ASCA required

answer

all claims send to Medicare be submitted electronically

question

The uniform claim form task force was replaced by

answer

National uniform claim committee

question

In 2012 the CMS-1500 claim form was revised to version 02-12 to accommodate

answer

IDC-10 Diagnosis codes

question

An insurance claim form that contains no staples or highlighted areas and on which the bar code area has not been deformed is called a

answer

physically clean claim

question

an insurance claim submitted with errors is referred to as a

answer

dirty claim

question

The CMS-1500 claim form is divided into which of the following major sectioin

answer

patient and physician information

question

The objective of the administrative simplification compliance act was to improve the administration of the medicare program by increased efficiencies resulting from

answer

electronic claims submission

question

ASCA provides exceptions to the medicare electronic claims submission requirement to

answer

small providers

question

Health insurance specialists should be familiar with the paper claim, as there may be occasions where the practice experiences technical ___ and is unable to submit claims electronically

answer

downtime

question

The NUCC is charged with the task of __ national instructions for completion of the CMS-1500 claim form

answer

Standardizing

question

the paper claim form was revised in 1990 and printed in red ink to allow __ of claims

answer

Optical scanning

question

the paper claim form was revised in 2005 to allow reporting of __ for physicians

answer

NPI

question

Effective __ the revised paper claim form (02-12) will be required for use by all providers

answer

Oct 1, 2013

question

the CMS-1500 paper claim can be purchased through a medical office supply company or through the

answer

AMA

question

a claim that is submitted to the insurance carrier via internet connection is referred to as

answer

electronic claim

question

a clean claim has no __ and passes all electronic edits

answer

deficiencies

question

Abstraction of technical information from patient records may be necessary to support medical

answer

necessity

question

When submitting a letter to an insurance company to explain unusual circumstances that should be considered when processing the claim, it should be sent to the attention of the

answer

claims supervisor

IHMO ch 7 worksheet 1

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