Explain how the payment plan affects reimbursement

Reference no: EM132364990

Assignment - CMS-1500 Claim Form Worksheet

Complete Parts A, B, and C of this worksheet.

Resource: CMS-1500 Completed Claim Form and Ch. 7 and Ch. 17 of Medical Insurance: A Revenue Cycle Process Approach (7th ed.)

Part A: CMS-1500 Claim Form

Imagine you work at a local medical office as a billing specialist. You are asked to audit the CMS-1500 claim form completed by a new employee to ensure it was completed correctly.

Review the patient information, provider information, and treatment information (information attached).

Review the CMS-1500 Completed Claim Form.

Determine if the employee input the correct data and correctly completed the data fields on the claim form.

Complete the table below by identifying the data field completed incorrectly and providing both the incorrect entry and correct entry. An example has been provided.

Data field	Incorrect entry	Correct entry
#26	Patient's account number listed as 12998	Correct account number is 18993

Write a 50- to 150-word response to each of the following questions. Be clear and concise, use complete sentences, and explain your answers using specific examples.

1. Explain the importance of complete and accurate completion of the claim form prior to claim processing.

2. Explain how the payment plan affects reimbursement.

Cite any outside sources. For additional information on how to properly cite your sources, utilize the Reference and Citation Generator resource.

Part B: Patient and Insurance Information Section of the CMS-1500 Claim Form

Review the patient information (attached).

Determine the appropriate content for each data field number listed. An example has been provided.

Data field number	Data field content
1	Medicare
1a
2
3
4
5
6

Part C: Physician or Supplier Information Section of the CMS-1500 Claim Form

Review the note (see in attached file).

Determine the appropriate content for each data field number listed. An example has been provided.

Data field number	Date field content
21	R73.9
24
24 F
25
26
28
32
33

Note - Please complete CMS-1500 Claim Form Worksheet as Microsoft word format.

Attachment:- Claim Form Worksheet.rar

Reference no: EM132364990

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