Chapter 2, Problem 2.11.1C

Drag the missing term into each sentence/paragraph text related to completion of the 837 P claim. The HIPAA 837P uses the term for the insurance diagnosis account or guarantor, meaning the same as on the CMS-1500 clalm. The name and address of any than the subscriber or patient who has is reported if applicable. party, the entity or person other responsibility for the bill, submission line filing indicator code is an administrative code used to identify data health the type of plan, such as a PPO. and the subscriber are not the same person, an code is required to specify the patient's relationship When the claim attachment individual to the subscriber. Although sometimes called the patient number, the claim number should not be the same as the practice's account insured electronic number for the patient. The claim code, also called the claim financial policyholder code, for physician practice claims indicates whether this claim is an original, a or needs to be voided. A total of four…

A patient received $800 medical procedure . The patient has an insurance plan with a 70/30 coinsurance agreement and a $200 deductible which they have not met . The insurance allows $550 on the procedure and the provider will write off the difference in cost . How much will the insurance be responsible for? How much will the patient be responsible for?

A patient receives a $420 medical procedure and has a 70/30 coinsurance agreement and a $100 deductible with their insurance company which they have not met. The insurance allows $300 on the procedure and the provider will write off the difference in cost. How much will the insurance be responsible for? How much will the patient responsible for?