Certified Revenue Cycle Representative (CRCR) Practice Exam

When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?

1. When the patient has a secondary insurance

2. When the patient is the insured

3. When the patient is a dependent

4. When the patient has no insurance

The correct answer is: When the patient is the insured

When "SAME" is entered in Field 0$ of the CMS 1500 billing form, it indicates that the patient is the insured. This terminology is crucial for billing as it clarifies the relationship between the patient and the financial responsibility for the medical services rendered. In this context, marking the patient as the insured ensures that the correct insurance information is processed. It distinguishes instances where the patient's coverage is directly tied to them, simplifying claims submissions and reducing potential errors in billing. This designation helps to streamline the revenue cycle, ensuring that claims are directed accurately to the appropriate insurance entity based on the patient’s role. Other potential entries in Field 0$ involve different relationships to the insurance policy. For example, marking a patient as a dependent or noting that they have secondary insurance would require different entries or indications that align with their specific coverage status. Each designation informs the billing department about how to approach the claim, but "SAME" clearly signifies direct insurance responsibility by the patient, making it a fundamental part of proper documentation in the billing process.