NCCT STUDY GUIDE (MOA) WITH
COMPLETE SOLUTIONS
The phrase __ was coined to indicate payment of services rendered by someone other than the patient -
Answer-Third-party reimbursement
Since 2005, providers have been urged to - Answer-Send claims electronically
The CMS-1500 form is accepted by - ...
third party reimbursement - Answer✔✔-The most Common of these are federal and state agencies,
insurance companies, and workers compensation
CMS-1500 - Answer✔✔-Standard claim form use for billing in medical offices
CMS-1450 (UB-04) - Answer✔✔-Paper claim form that may be submitted by an institutional provider
that meet certain requirements
Explanation of Benefits (EOB) - Answer✔✔-Form or document that may be sent to the patient by their
insurance company after they have had a healthcare service that was paid by the insurance company
may take up to several months to receive
Standard Electronic Data Interchange (EDI) Enrollment form - Answer✔✔-This must be completed before
submitting electronic media claims to Medicare
remittance advice - Answer✔✔-Similar to the EOB But is the document provided by the payer to the
provider
Manual insurance log - Answer✔✔-Use of these allows a medical facility or providers office to submit
transactions faster and be paid sooner
Signature on File (SOF) - Answer✔✔-Patient signature on a form that permits the release of his or her
information allowing the claim to be filed on his or her behalf
Assignment of benefits clause - Answer✔✔-Authorizes benefits to be paid directly from a third party
payer to a provider
Electronic Data Interchange (EDI) transactions - Answer✔✔-Book in which a list of insurance claims is
kept
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