Explore the intricacies of medical billing in 'Lucky Luciano's Insurance: Chapter 11 CMS-1500'. This quiz covers physician service billing, surgical complications, global fees, and specialized billing scenarios, enhancing understanding of CMS-1500 form usage and procedure coding.
Lower case
Sentence case
Title case
Upper case
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Billed as an additional surgical procedure
Coded for office data capture purposes only
Included as part of the original procedure
Not reported on the CMS-1500 or UB-04
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Acute care hospital
Insurance company
Medical practice
Patient or (spouse)
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A patients inpatient stay was prolonged due to medical or psychological complications.
Charges submitted to the payer are lower than the providers normal fee( -22 added to code)
Surgery defined as an inpatient procedure was performed while the patient was in the hospital
Surgery typically categorized as an office procedure was performed in a hospital outpatient setting
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DRG payments
Multiple charges
One charge
Separate charges
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Combined medical/surgical case
Fee-for service charge
Global fee
Itemized list of separate charges
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The payer is instructed to reimburse the provider directly
The payer sends reimbursement for services to the patient
The provider accepts as payment what the payer reimburses
The provider cannot collect copayments from the patient
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Disability
Homeowners
Life
Managed care
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Convert CMS-1500 claims
Enter CMS-1500 claims
Scan CMS-1500 claims
View CMS-1500 claims
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