Question

This form contains major items, subdivided into a total of 55 detailed items, and is used by professional service providers and not hospitals for submitting claims for services to health plans this form is called:

a) CMS-1500
b) UB-04
c) HCFA-486
d) ADA-2000

Answer 1

The form used by professional service providers to submit claims for outpatient services to health plans is the CMS-1500. It is part of the Part B insurance system, which covers various medical services outside of hospital stays.

Step-by-step explanation:

The form used by professional service providers for submitting claims for services to health plans, which includes major items subdivided into a total of 55 detailed items, is known as CMS-1500. This form is distinct from the UB-04 form, which is typically utilized by hospitals. The CMS-1500 is essential for healthcare professionals who provide outpatient services covered under Part B, an optional insurance system that includes coverage for physician services, medical tests, and outpatient visits. Individuals who opt into this system pay a monthly fee, deductible charges, and copayments, while the government covers about three-fourths of the overall costs.