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Hospital Billing 2nd Edition by Susan Magovern,Jean Jurek
Edition 2ISBN: 978-0073520896Hospital Billing 2nd Edition by Susan Magovern,Jean Jurek
Edition 2ISBN: 978-0073520896 Exercise 8
Fill in FLs 50-65 below for patient Maria Giorgo, given the following insurance and patient information. The hospital's NPI is 3322100065.Insurance Information
Patient Information
Primary: Empire BC/BS
Patient's Name: Maria Giorgo
Plan ID/Carrier Code: 00444
Insured's Name: Maria Giorgo
Release of Info on File: Y
Patient Relationship to Insured: Self
Benefits Assigned: Y
Insured's Plan ID: 99-2305
Preauthorization Number: 0022798
Insurance Group Name/No: 8402-S92
Provider ID: Y1002Q
Employer: Towne Drug
UB-04 Form - FLs 50-65
974_13_180_Q_2
Patient Information
Primary: Empire BC/BS
Patient's Name: Maria Giorgo
Plan ID/Carrier Code: 00444
Insured's Name: Maria Giorgo
Release of Info on File: Y
Patient Relationship to Insured: Self
Benefits Assigned: Y
Insured's Plan ID: 99-2305
Preauthorization Number: 0022798
Insurance Group Name/No: 8402-S92
Provider ID: Y1002Q
Employer: Towne Drug
UB-04 Form - FLs 50-65
974_13_180_Q_2
Explanation
Verified
Verified
Hospital Billing 2nd Edition by Susan Magovern,Jean Jurek
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