Claim Form Challenge

Froggy Jumps

Played 132

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About this activity

Test your knowledge on completing a claim form with this fun quiz game! Review the CMS-1500 images and chapter material to help you along.

Created by

Lythia

United States

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Top 10 results

#	Player	Accuracy	time
1	Melanie P November 11, 2025	% 100	01:28
2	Em March 24, 2025	% 100	01:37
3	shell November 12, 2025	% 100	01:42
4	abigail March 24, 2025	% 100	01:55
5	Amanda November 12, 2025	% 90	01:27
6	Kadesha Watkins March 24, 2025	% 90	01:45
7	jordyan w November 12, 2025	% 90	01:52
8	raerae March 22, 2025	% 90	01:58
9	Takaylia November 14, 2025	% 90	02:09
10	Hailey March 24, 2025	% 90	02:12

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Claim Form Challenge


Froggy Jumps Claim Form ChallengeOnline version Test your knowledge on completing a claim form with this fun quiz game! Review the CMS-1500 images and chapter material to help you along. by Lythia 1 What is the first step in completing a claim form? a Submit the form immediately. b Gather necessary patient and encounter information. c Contact customer service. 2 Which information is typically required on a claim form? a Bank account details. b Social security number. c Policy number. 3 What information should be entered in the upper right corner of the claim form? a Insuranced's ID b Patient name c Insurance Carrier Name and Claims address 4 What information is entered in boxes 1-7 on a CMS-1500 form a Insurance Carrier Name and Address from insurance card b Patient and Insured's demographics from PHI form c Provider Name and Office Address 5 What should enter in boxes 9-11 on a claim form? a Insurance information, Name, ID#, Group #, Insured's DOB, gender b Unrelated receipts. c Personal letters. 6 How can you track the status of your claim? a Use the tracking number provided. b Call any number. c Check social media. 7 Why is it important to keep copies of your claim form? a For your records and future reference. b To share with friends. c To throw away later. 8 What should you do if your claim is denied? a Review the denial reasons and appeal if necessary. b Resubmit the same claim. c Ignore the denial. 9 What is a common reason for claim denial? a Too much detail. b Incomplete information. c Submitting too early. 10 What information goes in boxes 12-13? a Provider's signature or "PSOF" b Patient Signature or "SOF" c Signature of person completing the form 11 Where would you locate the information needed to complete the claim form? a Patient registration documents, Insurance Card copies, and patient EHR encounter b Previous claim forms and encounters c Ask the doctor 12 What information is needed for boxes 14-20? a Dates, hospitalization, referrering provider and outside lab charges b Dates, procedures and services provided and charges c Dates and Provider billing information and charges 13 What type of information is needed to complete box 21? a procedure codes b referring provider name c diagnosis codes 14 What type of information is required for boxes 24a-24j? a DOS, POS, procedure codes, charges and provider ID b POS, diagnosis codes, charges and provider ID c Lab charges, provider ID and Prior authorization number 15 When should box 23 be completed? a Never it should always be blank b When charging for outside labs c When Prior Authorization was required 16 Boxes 25-33 contain what type of information? a Charges and Patient Billing information b Referring Provider Information c Provider Name and Billing Information

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Claim Form Challenge

Froggy Jumps

About this activity

Created by

Download the paper version to play

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Claim Form ChallengeOnline version

by Lythia

What is the first step in completing a claim form?

Which information is typically required on a claim form?

What information should be entered in the upper right corner of the claim form?

What information is entered in boxes 1-7 on a CMS-1500 form

What should enter in boxes 9-11 on a claim form?

How can you track the status of your claim?

Why is it important to keep copies of your claim form?

What should you do if your claim is denied?

What is a common reason for claim denial?

What information goes in boxes 12-13?

Where would you locate the information needed to complete the claim form?

What information is needed for boxes 14-20?

What type of information is needed to complete box 21?

What type of information is required for boxes 24a-24j?

When should box 23 be completed?

Boxes 25-33 contain what type of information?