Explanation of forms, including the CMS 1500 and UB-04, should include
- key term
- historical development of CMS reimbursement systems
- special rules for the Medicare physician fee schedule payment system
- chargemaster
- hospital revenue cycle management
- appeal process
- completion of forms for
- workers’ compensation
- Blue Cross/Blue Shield
- Medicare
- Medicaid
- TRICARE.
Process/Skill Questions:
- When is a 1500 form used vs. an UB-04 form?
- What are common mistakes made when filling out forms?
- What is a clean claim vs. a dirty claim?
- What are the steps to an appeal?