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Pages:
1 page/≈275 words
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Style:
APA
Subject:
Health, Medicine, Nursing
Type:
Essay
Language:
English (U.S.)
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MS Word
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Topic:
Process of Auditing Claim Forms
Essay Instructions:
Examine the process of auditing the claim forms (CMS-1500 AND UB-04). Outline the important things you have learned about completing the claim forms correctly. Summarize the appropriate steps to ensure you are producing a clean claim that is going to be paid for by the insurance company.
Essay Sample Content Preview:
Process of Auditing Claim Forms
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Process of Auditing Claim Forms
A claim form is a document used to make a formal request to an insurance company for coverage or compensation for a covered loss or policy event. It is from this formal request that an insurance company validates a claim for compensation and once it approves it, it issues the payment to the insured or an approved beneficiary on behalf of the insured (Thomas & Ilhm,2016).CMS-500 is a Medical Insurance Claim Form. It is used by physicians and suppliers for claim billing.UB-04 on the other hand are a claim form used by hospitals, nursing facilities, in-patient to bill Medicare Administrative Contractors (MACs) when a paper claim is allowed.
To audit a CMS-1500 form the insurance company needs the insured person’s the provider’s name, phone number, office address, NPI number and social security/tax number. The company will then promp...
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