Bundle: Understanding Health Insurance: A Guide To Billing And Reimbursement, 14th + Law, Liability, And Ethics For Medical Office Professionals, 6th ... For Green's Understanding Health Insu
14th Edition
ISBN: 9780357014738
Author: Michelle Green
Publisher: Cengage Learning
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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. 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…arrow_forwardYou are caring for a client with diabetes. You notice that the client is forcing his shoes on over very swollen feet and the shoes are extremely tight. He denies any discomfort. Is this a problem? How would you go about the situation?arrow_forwardCoordination of benefits (COB) includes: Reimbursement when a patient is covered by more than 1 health plan Reimbursement for non-covered services Reimbursement for not medically necessary services Reimbursement for diagnosis mismatcharrow_forward
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