CHAPTER 14: THE PAPER CLAIMS CMS-1500 QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+
Digital files that are not printed on claim forms when submitted to the
payers
- The ASCA was enacted by Congress to improve administration of the
Medicare program by increasing efficiencies gained through these
submissions. Ans✓✓✓electronic claims
The ________ provides an exception to the Medicare electronic claims
submission requirements to small health care organizations
Ans✓✓✓ASCA
Despite the transition to electronic claims submission, the paper claim
continues to be an important part of the claims process that the insurance
billing specialist must learn as a basic skill set.
(T or F) Ans✓✓✓True
The ASCA also allows an exemption to any health care organization
who may be in an area that has disruptions in electricity and
communication connections beyond control and expected to last more
than 2 business days. Ans✓✓✓poor technology
Paper claims often are used when __________ special services or
require special processing because of unusual circumstances.
Ans✓✓✓reporting
, Paper claims are often used when ______________ a claim for review
after initial denial of claim. Ans✓✓✓resubmitting
What is the basis for electronic claim submission, and many software
and hardware systems depend on the CMS-1500 claim form?
Ans✓✓✓paper claim
The CMS 1500 claim for was developed by this organization
- co-chaired by AMA and CMS
- authoritative voice regarding national standard content
Ans✓✓✓NUCC
Per Medicare guidelines, the _______ ________ versions of the CMS-
1500 claim form cannot be duplicated. Ans✓✓✓red ink
the claim forms must be originals and not photocopies or they will not
be processed. Ans✓✓✓no copies
a claim that was submitted within a third party payer's time limit and
contains all the necessary information so that it can be processed and
paid promptly Ans✓✓✓clean claim
clean claim means the following: Ans✓✓✓1. The claim has no
deficiencies and passes all electronic edits
AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+
Digital files that are not printed on claim forms when submitted to the
payers
- The ASCA was enacted by Congress to improve administration of the
Medicare program by increasing efficiencies gained through these
submissions. Ans✓✓✓electronic claims
The ________ provides an exception to the Medicare electronic claims
submission requirements to small health care organizations
Ans✓✓✓ASCA
Despite the transition to electronic claims submission, the paper claim
continues to be an important part of the claims process that the insurance
billing specialist must learn as a basic skill set.
(T or F) Ans✓✓✓True
The ASCA also allows an exemption to any health care organization
who may be in an area that has disruptions in electricity and
communication connections beyond control and expected to last more
than 2 business days. Ans✓✓✓poor technology
Paper claims often are used when __________ special services or
require special processing because of unusual circumstances.
Ans✓✓✓reporting
, Paper claims are often used when ______________ a claim for review
after initial denial of claim. Ans✓✓✓resubmitting
What is the basis for electronic claim submission, and many software
and hardware systems depend on the CMS-1500 claim form?
Ans✓✓✓paper claim
The CMS 1500 claim for was developed by this organization
- co-chaired by AMA and CMS
- authoritative voice regarding national standard content
Ans✓✓✓NUCC
Per Medicare guidelines, the _______ ________ versions of the CMS-
1500 claim form cannot be duplicated. Ans✓✓✓red ink
the claim forms must be originals and not photocopies or they will not
be processed. Ans✓✓✓no copies
a claim that was submitted within a third party payer's time limit and
contains all the necessary information so that it can be processed and
paid promptly Ans✓✓✓clean claim
clean claim means the following: Ans✓✓✓1. The claim has no
deficiencies and passes all electronic edits
