Chapter 7 - Insurance Completion,Matching

The Health Claim Form, also known as the universal claim form, is often called or referred to as?

CMS-1500

A claim that is submitted to the insurance carrier via a dial-up modem is referred to as?

Electronic Claim

A husband and wife both have insurance through their employers, and each has added the spouse to their insurance plans for coverage. If the wife is seen for treatment, then her plan is considered?

Primary

an insurance claim that is submitted within the program or policy time limit and correctly completed.

clean claim.

an insurance claim that is submitted with errors.

dirty claim.

When the patient is insured by two companies, the coverage is sometimes referred to as ?

dual coverage

an insurance claim that is submitted via a dial-up modem or direct data entry.

electronic claim

A medicare claim that is missing required information.

incomplete claim.

A medicare claim that contains complete, necessary information but is illogical or incorrect.

invalid claim

an insurance claim that is submitted on paper, including optically scanned claims?

paper claim

an insurance claim held in suspense due to reveiw or other reason.

pending claim.

an insurance claim that requires investigation and needs further clarification?

rejected claim