Using the CMS-1500 form, fill out the form for a non-Hodgkin’s lymphoma (page 183 of text)

Introduction:

While it is true that the CMS-1500 claim form may not be used for private-pay patients, this form will be required for all claims when the patient is covered by any form of insurance to recover payment for services. A working knowledge of the CMS-1500 is essential for all persons working in the revenue and billing area of healthcare.

TASKS:

Using the CMS-1500 form, fill out the form for a non-Hodgkin’s lymphoma (page 183 of text) and a radiological Oncology treatment (page 278 of text). For assistance with completing and saving a PDF document, please click here

Use patient information found on EOB Figure 4-17 of text (page 90).

Describe the process of submitting this claim form through a third-party administrator.

SUBMISSION DETAILS:

• Submit both the completed claim form and a 1- to 2-page reflection on the process as a Microsoft Word document. Use APA standards for citations and references.
• Cite a minimum of three outside peer-reviewed sources to support your assertions and save it as SU_HCM1201_W2_Project_LastName_FirstInitial.doc. Submit the process to the Submissions Area by the due date assigned.
• Cite any sources using correct APA format on a separate page.

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