Shopping Cart
Your shopping cart is empty!

HCR 220 Week 8 Checkpoint Complete a CMS-1500 Claim Form

HCR 220 Week 8 Checkpoint Complete a CMS-1500 Claim Form
Model:Recent
Price: $5.00 $3.50
Qty:   Check out
This Tutorial was Purchased: 6  Times   & Rated: A by student like you.

attachments This Tutorial contains following Attachments:

  • Week 8 - Checkpoint - Complete a CMS-1500 Claim Form.pdf

HCR 220 Week 8 Checkpoint Complete a CMS-1500 Claim Form

Checkpoint: Complete a CMS-1500 Claim Form
 
Complete the CMS-1500 claim form worksheet located in Appendix C. If you believe information provided in the following list is insufficient to adequately fill a required field with data, for example, to supply a specific diagnosis code, indicate this by typing N/A.
Name: Jane Smith
Insurer: TRICARE
Policy Number: 123456
ID number: 999000666
DOB: 01/01/1950
Gender: Female
Insured: James Smith, spouse
Address: 1111 Noname Court, Nowhere, NY 22222
Marital Status: Married
Patient’s Employer: Homemaker
Spouse’s Employer: U.S. Army
Nature of Condition: Routine exam
Patient Signature

 

Write a review

Your Name:


Your Review: Note: HTML is not translated!

A   B   C   D   F  

Enter the code in the box below:



Top