In reviewing the different Blocks on the CMS 1500 form, choose a section of Blocks (as discussed in the unit) and in your own words: List the Block Numbers (i.e., Blocks 1-8), Describe what information goes into the Blocks Discuss any formatting requirements for the Blocks and what happens to a claim if the formatting is incorrect. In the second document above, CMS discusses Incomplete or Invalid Submissions. Explain how the Part A/Part B Medicare Administrative Contractors (MAC) handles these types of claims. CMS also discusses the difference between a “clean claim” and “other-than-clean claims.” Explain in your own words the timeliness standards for processing for “other-than-clean claims.”

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
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With the use of Electronic Health Records most healthcare facilities and offices no longer submit a paper claim form instead of the fields in the EHR translate in the background to an electronic format of the CMS 1500 (physician claim) or a UB04 (hospital claim) form. However, it is still essential that you understand how to complete a claim form properly.

  1. In reviewing the different Blocks on the CMS 1500 form, choose a section of Blocks (as discussed in the unit) and in your own words:
    • List the Block Numbers (i.e., Blocks 1-8),
    • Describe what information goes into the Blocks
    • Discuss any formatting requirements for the Blocks and what happens to a claim if the formatting is incorrect.
  2. In the second document above, CMS discusses Incomplete or Invalid Submissions. Explain how the Part A/Part B Medicare Administrative Contractors (MAC) handles these types of claims.
  3. CMS also discusses the difference between a “clean claim” and “other-than-clean claims.” Explain in your own words the timeliness standards for processing for “other-than-clean claims.”

Please be sure to validate your opinions and ideas with citations and references in APA format. Review the Herzing University Student Code of Conduct Policy Download Herzing University Student Code of Conduct Policy(re: plagiarism). 

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