CMS 1500 Form and Vocabulary

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Across
  1. 2. Process by which an insurance carrier allows a provider to submit insurance claims directly to the carrier.
  2. 4. A ________ claim has been completed accurately and completely.
  3. 7. Section 1 of the CMS 1500 Form is for what information?
  4. 8. Acts as an intermediary between the healthcare facility and health insurance company.
  5. 10. A process of determining if a procedure or service is covered by the insurance plan.
  6. 11. Unintended action that directly or indirectly results in an overpayment to a healthcare provider.
  7. 12. The Medical Assistant should always follow office _________ for claim review and signatures.
Down
  1. 1. Is known as the Insured or is the person who has purchased and owns an insurance policy.
  2. 3. The provider is paid a set amount for each enrolled person assigned to them.
  3. 5. Section 2 of the CMS 1500 Form is for what information.
  4. 6. Knowingly and willfully executing a scheme to defraud any healthcare benefit program.
  5. 9. A document sent by the insurance company to the patient and provider explaining the allowed charge amount, reimbursement and patient financial responsibility.