CMS-1500 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+
CMS-1500 Ans✓✓✓used to request payment from health insurance
payers, like Medicare, after a patient has been treated. To fill out the
form you must have:
-the patient registration form
-patient health record documentation
-superbill/encounter form
patient registration form Ans✓✓✓contains the patient's demographic
information and health insurance payer information. This information
must be up to date, and most practices will institute a policy of verifying
the information upon each visit. This form is usually accompanied by
photocopies of the insurance card(s) to ensure accurate spelling, group
numbers, and contact information.
patient health record documentation Ans✓✓✓comprised of all of the
information pertaining to the assessment and treatment of the patient.
Generally, these will be separated by encounter.
superbill/encounter form Ans✓✓✓This preprinted form is filled out on
each visit and contains the codes that are used in the particular
healthcare setting. This form will have the diagnosis codes and
procedure codes designated by the physician at the completion of the
encounter.
, How should the CMS-1500 be filled out? Ans✓✓✓with all capital
letters and no punctuation
"CARRIER" Ans✓✓✓this is where the name and address of the third-
party payer handling the claim will go
PATIENT AND INSURED INFORMATION Item 1 Ans✓✓✓will
require you to identify the type of health insurance held by the patient.
The correct insurance type will be marked with a capital X
PATIENT AND INSURED INFORMATION Item 1a
Ans✓✓✓identifying number of the person who is insured by the policy.
This is found on the insurance identification card.
PATIENT AND INSURED INFORMATION Item 2 Ans✓✓✓will
include the patient's full name: last name, first name, and middle initial.
Only use the punctuation or suffixes (e.g., Jr., III) exactly as they appear
on the patient's insurance card.
PATIENT AND INSURED INFORMATION Item 3 Ans✓✓✓contains
two fields. The first piece of information in this field is the patient's date
of birth. This must be entered in the MM DD YYYY format (e.g., 09 22
19XX). There is also a place to indicate whether the patient is male or
female in this field.
(VERIFIED ANSWERS) ALREADY GRADED A+
CMS-1500 Ans✓✓✓used to request payment from health insurance
payers, like Medicare, after a patient has been treated. To fill out the
form you must have:
-the patient registration form
-patient health record documentation
-superbill/encounter form
patient registration form Ans✓✓✓contains the patient's demographic
information and health insurance payer information. This information
must be up to date, and most practices will institute a policy of verifying
the information upon each visit. This form is usually accompanied by
photocopies of the insurance card(s) to ensure accurate spelling, group
numbers, and contact information.
patient health record documentation Ans✓✓✓comprised of all of the
information pertaining to the assessment and treatment of the patient.
Generally, these will be separated by encounter.
superbill/encounter form Ans✓✓✓This preprinted form is filled out on
each visit and contains the codes that are used in the particular
healthcare setting. This form will have the diagnosis codes and
procedure codes designated by the physician at the completion of the
encounter.
, How should the CMS-1500 be filled out? Ans✓✓✓with all capital
letters and no punctuation
"CARRIER" Ans✓✓✓this is where the name and address of the third-
party payer handling the claim will go
PATIENT AND INSURED INFORMATION Item 1 Ans✓✓✓will
require you to identify the type of health insurance held by the patient.
The correct insurance type will be marked with a capital X
PATIENT AND INSURED INFORMATION Item 1a
Ans✓✓✓identifying number of the person who is insured by the policy.
This is found on the insurance identification card.
PATIENT AND INSURED INFORMATION Item 2 Ans✓✓✓will
include the patient's full name: last name, first name, and middle initial.
Only use the punctuation or suffixes (e.g., Jr., III) exactly as they appear
on the patient's insurance card.
PATIENT AND INSURED INFORMATION Item 3 Ans✓✓✓contains
two fields. The first piece of information in this field is the patient's date
of birth. This must be entered in the MM DD YYYY format (e.g., 09 22
19XX). There is also a place to indicate whether the patient is male or
female in this field.
