Question

Review Questions Match the key terms with their definitions. 1. LO 7.3 billing provider 2. LO 7.7 clean claim 3. LO 7.6 destination payer 4. LO 7.6 line item control number 5. LO 7.3 pay-to provider 6. LO 7.4 POS code 7. LO 7.8 claim scrubber 8. LO 7.4 rendering provider 9. LO 7.5 subscriber 10. LO 7.4 taxonomy code 11. LO 7.2 carrier block 12. LO 7.1 CMS-1500 A. Claim accepted by a health plan for adjudication . Unique number assigned by the sender to each service line on a claim Software used to check claims Stands for the type of provider specialty Entity providing patient care for this claim if other than the billing/ pay-to provider Entity that is to receive payment for the claim Stands for the type of facility in which services reported on the claim were provided Insurance carrier that is to receive the claim Entity that is sending the claim to the payer The insurance policyholder or guarantor for the claim Paper claim for physician services The data entry area in the upper right portion of the CMS-1500 chapter 7 revi

Answer 1

ANSWER.

* Billing provider - I) Entity that is sending claim to the payer.

* Clear claim - A) Claim accepted by a health plan for adjudication.

* Destination payer - H) Insurance carrier that is to receive the claim.

* Line item control number - B) Unique number assigned by sender to each service line

                                                   on a claim.

* Pay to provider - F) Entity that is to receive payment for the claim.

* POS code - G) Stand for the type of facility in which services reported on the claim

                            were provided.

* Claim scrubber - C) Software used to check claims.

* Rendering provider - E) Entity providing patient care for this claim if other than the billing/pay to

                                     provider.

* Subscriber - J) The insurance policy holder or guarantor for the claim.

* Taxonomy code - D) Stand for type of providers specialty.

* Carrier block - L) Data entry area in the upper right portion of the CMS -1500.

* CMS-1500 - K) Paper claim for physicians services.