Chapter Highlights Medical Insurance means many things to many people. To some, it is a mound of paperwork. To other's it is a mass of confusion and replication that seems to change constantly. For a patient with an illness or injury, health insurance helps defray the high cost associated with healthcare.
| There are both paper, or hardcopy claims, and electronic forms that are used to file health care claims for reimbursement.
| This week we will examine both types of claim forms, and learn to complete a CMS 1500 form. By the end of this chapter you will be able to explain how to gather information necessary to successfully complete a claim form.
| Accurate completion of the CMS-1500 claim form begins with the gathering of the patient's and the insured's demographic and insurance information; the diagnoses and the procedures and services performed; and the provider's identifying information.
| The patient registration form is used to collect the patient's and insured's information, and confirmation of all collected information is an important task that should not be neglected.
| This can be done by photocopying the patient's and insured's insurance cards and driver's licenses; verifying eligibility and benefits; and, when applicable, securing approval from the insurance payer in advance for procedures, services, and referrals.
| A wise medical assistant creates a checklist of all the information needed to complete an insurance claim correctly.
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Chapter 12 Highlights The Musculoskeletal System subsection classifies procedures performed on bones, cartilage, joints, ligaments, muscles, and tendons and includes casting and strapping.
| The CPT Musculoskeletal System subsection is arranged from head to toe according to body area and includes the following headings: General, Head, Neck and Thorax, Back and Flank, Spine, Abdomen, Shoulder, Humerus and Elbow,...
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