Week 3 Introduction: Practice makes perfect. This week you have the opportunity to practice system one of the most common forms in medical billing, the CMS 1500 form for submission to a variety of insurance payers. You will learn the revenue implication of submitting a clean claim and the impact on your current or future employer . Week 3 Objectives: Compare and contrast medical insurance payers and Complete CMS-1500 form.

Required Resource:

ISBN: 978-0-07-351371-3

Valerius, J., Bayes, N., Newby, C., Blowchowiak, A. (2012). Medical Insurance, an Integrated Claims Process Approach. (6th Ed.), New York, NY: McGraw-Hill Publishers.

• Chapter 7
• Chapter 8
• Chapter 9
• Chapter 10
• Chapter 11
• Chapter 12

ISBN: 978-0-7637-5964-3

Valerius, J., Bayes, N., Newby, C., Blowchowiak, A. (2012). Medical Insurance Workbook. New York, NY: McGraw-Hill Publishers.

Weblinks:

• CMS 1500 Form:

  http://highered.mcgraw-hill.com/sites/0073513717/student_view0/cms_1500_and_ub-04_forms.html#

Written Assignment ” CMS-1500

Lead in:

The CMS-1500 is a paper claim for physician services that is accepted by most payers. Reimbursement professionals working in physician practices need to develop proficiency in completing the CMS-1500. This will give you an opportunity to practice this skill which will make you an asset to any future employer.

To prepare for this assignment:

• Read Chapter 7 in the Medical Insurance, an Integrated Claims Process Approach
• Download the CMS-1500 form:

  http://highered.mheducation.com/sites/0073513717/student_view0/cms_1500_and_ub-04_forms.html#

With this in mind,

Using the Interactive CMS-1500 Form, complete the following:

• Five (5) BC/BS
• Five (5) Medicare
• Five (5) Medicaid
• Two (2) Tricare
• Two (2) Workman”s Comp

Use ideas from the class text and your own experiences to create make believe scenarios and complete the claims bulleted above. Be sure to provide a very brief scenario with each claim (i.e. patient broke arm and had surgery); a different scenario should be used for each claim. Data can be input and saved as a .pdf in the link provided.