Business > CASE STUDY > HS215 Medical Insurance and Billing Unit 2 Assignment LBrown 1 .docx HS215 Medical Insu (All)
HS215 Medical Insurance and Billing Unit 2 Assignment LBrown 1 .docx HS215 Medical Insu
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HS215_Medical_Insurance_and_Billing_Unit_2_Assignment_LBrown_1_.docx HS215 Medical Insurance and Billing Purdue University Global Unit 2 Assignment Assignment: Encounter forms are used to g... enerate insurance claims. They contain patient identification information, the date of service, and abbreviated diagnosis and procedure codes. The provider checks or circles the appropriate codes on the encounter form, and the insurance specialist enters the data (office charge, amount paid by the patient, and the total due). Review the encounter form for JOHN SMITH which is located in Course Documents. Answer the following questions in a Word document: Please refer to Chapter 6 and Chapter 11. 1.During processing of the encounter form (to generate the claim), the billing specialist notices that the provider entered a checkmark in front of the procedure, “Hemoccult Stool,†and a check mark in front of the diagnosis, “Gout.†Because medical necessity requires the diagnosis selected to justify the procedure performed, what should the billing specialist do next? 2.The provider will accept whatever the payer determines is the allowed fee as payment in full. Should the provider enter a check mark in the YES box for “ACCEPT ASSIGNMENT†on the CMS1500? What is the ITEM NUMBER(s) of the section of the CMS 1500 form that the patient signs to authorize payment to the provider? 3.Refer to the CMS-1500 claim form found in your text. Which block on this form would contain an entry based on information contained in the encounter . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. .. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [Show More]
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