NEED A PERFECT PAPER? PLACE YOUR FIRST ORDER AND SAVE 15% USING COUPON:

Case Study 1-4 Reimbursement Methodologies – Week 6 Assignment Case Study 1-4 Use the registration form to complete a CMS-1500 Claim Form for a BCBS Pati

Case Study 1-4 Reimbursement Methodologies – Week 6 Assignment

Case Study 1-4

Use the registration form to complete a CMS-1500 Claim Form for a BCBS Pati

Click here to Order a Custom answer to this Question from our writers. It’s fast and plagiarism-free.

Case Study 1-4 Reimbursement Methodologies – Week 6 Assignment

Case Study 1-4

Use the registration form to complete a CMS-1500 Claim Form for a BCBS Patient.

Open the patient registration information.

Open a blank fillable CMS-1500 form.

When doing this assignment, remember to:

·  Use the NUCC Instructions to complete your CMS-1500

·  Review your completed form for errors SimClaimTM Case Studies: Set One

Case Study 1-4
Katlyn Tiger

ARNOLD YOUNG MD
21 PROVIDER STREET
INJURY NY 12347

101 2027754

EIN: 111234632

PATIENT INFORMATION:
Name: TIGER, KATLYN
Address: 2 JUNGLE ROAD
City: NOWHERE
State: NY
Zip/4: 12346-1234
Telephone: 101 1112222

Gender: M F x
Status: Single x Married Other
Date of Birth: 01 03 1954
Employer: JOHN LION CPA
Student: FT PT School:

Work Related? Y N x
Auto Accident? Y N x State:
Other Accident: Y N x
Date of Accident:

Referring Physician:
Address:
Telephone:
NPI #:

Patient Number: 1-4

NPI: 0123456789

Primary Insurance Name: BLUECROSS BLUESHIELD
Address: PO BOX 1121
City: MEDICAL
State: PA
Zip/4: 12357-1121

Plan ID#: ZJW334444
Group #: W310
Primary Policyholder: TIGER, KATLYN
Address: 2 JUNGLE ROAD
City: NOWHERE
State: NY
Zip/4: 12346-1234
Policyholder Date of Birth: 01 03 1954
Pt Relationship to Insured: Self x Spouse Child Other
Employer/School Name: JOHN LION CPA

INSURANCE INFORMATION:
Primary Insurance

Secondary Insurance
Secondary Insurance Name:
Address:
City:
State:
Zip/4:

Plan ID#:
Group #:
Primary Policyholder:
Address:
City:
State:
Zip/4:
Policyholder Date of Birth:
Pt Relationship to Insured: Self Spouse Child Other
Employer/School Name:

ENCOUNTER INFORMATION:
Place of Service: 22

DIAGNOSIS INFORMATION

PROCEDURE INFORMATION

Description of Procedure/Service

1. INITIAL OBSERVATION, COMPREHENSIVE

Dates Code Mod
Unit
Charge

Days/
Units

Code

1. J18.0 BRONCHOPNEUMONIA

Diagnosis Code

5.

Diagnosis

2.

3.

4.

3.

4.

5.

6.

Special Notes: CARE RENDERED AT GOODMEDICINE HOSPITAL, 1 PROVIDER STREET, ANYWHERE, NY 12345, NPI: 1123456789.
ADMISSION 2/28/YYYY DISCHARGE 3/1/YYYY

02 28 YYYY

03 01 YYYY

99220

99217

175 00

65 00

1

1

6.

7.

8.

2. DISCHARGE HOME

Place your order now for a similar assignment and have exceptional work written by one of our experts, guaranteeing you an A result.

Need an Essay Written?

This sample is available to anyone. If you want a unique paper order it from one of our professional writers.

Get help with your academic paper right away

Quality & Timely Delivery

Free Editing & Plagiarism Check

Security, Privacy & Confidentiality