Learning Outcomes
After studying this chapter, you should be able to:
Discuss the content of the patient information section of the CMS-1500 claim. |
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Discuss the content of the physician or supplier information section of the CMS-1500 claim. |
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Describe use of a practice management program to prepare claims. |
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Compare required and situational data elements. |
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Identify the five sections of the HIPAA 837 claim transaction, and discuss the data elements that complete it. |
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Compare billing provider, pay-to provider, rendering provider, and referring/ordering provider. |
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Distinguish between a claim control number and a line item control number. |
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Discuss the role of clearinghouses in preparing HIPAAcompliant claims. |
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Explain how claim attachments and credit–debit information are handled. |
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Identify the three major methods of electronic claim transmission. |