How are the data elements in the HIPAA Act

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Reference no: EM132364984

Medical Claims Processing and Compliance Assignment - Claims Worksheet

Part A: Claims Process

Resource: This week's readings from Medical Insurance: A Revenue Cycle Process Approach (7th ed.)

Write a 75- to 150-word response for each of the following questions. Use your own words and provide examples to support your answers.

1. How are the data elements in the Health Insurance Portability and Accountability Act (HIPAA) 837 claim form similar to the CMS-1500?

2. How does each form relate to the claims process?

3. In your opinion, do the similarities between HIPAA 837 and CMS-1500 complicate or simplify the claims process? Explain your answer.

Part B: UB-04 Form

Resources: The following sections from Medical Insurance: A Revenue Cycle Process Approach (7th ed.):

Section 17.6 in Ch. 17
Figure 17.4: UB-04 Form
Table 17.1: UB-04 Form Completion

Review the resources listed above.

Complete the tables below.

Determine the data field number where the data given should be placed on the UB-04 form. An example has been provided.

Data Field Number	Data
3a	The patient's control number
	The patient's name
	The patient's date of birth
	Admission date
	Source of admission-Point of origin of admission
	Admission hour
	Occurrence codes
	Revenue codes
	Revenue code description
	Total charges
	Estimated amount due
	Insured's name
	Insured's group number
	Diagnosis codes
	Procedure codes
	Principal diagnosis
	Admitting diagnosis
	External cause of injury
	Attending provider's name
	Operating physician's name

Determine the data that needs to be listed under the data field number given of the UB-04 form. An example has been provided.

Data Field Number	Data
1	Provider's name and address
3b
5
9
13
14
17
18-28
29
39-41

Note - Please complete Claims Worksheet as Microsoft word format.

Reference no: EM132364984

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