In this assignment, you will apply your knowledge of the insurance claim lifecycle and government-sponsored insurance programs by accurately completing a CMS-1500 claim form using the EHRGo platform. You will review patient demographics, insurance information, and clinical services to ensure proper claim creation. This activity demonstrates how claim accuracy affects reimbursement, denials, appeals, and compliance within the revenue cycle.
Instructions
Step 1: Access the EHRGo Assignment
Log in to EHRGo using the access code provided by your instructor.
Locate the CMS-1500 Claim Creation activity in the course assignments.
Click Launch EHR to access the patient chart and assignment details.
Step 2: Review the Patient Information
Carefully review all sections of the patient record, including:
Demographics
Insurance details (e.g., payer, coverage type, plan rules)
Provider information
Clinical services and charges
Pay attention to required CMS-1500 data fields for accurate billing and reimbursement.
Step 3: Complete the CMS-1500 Claim Form
Using the information provided:
Enter all required patient, provider, and insurance data on the CMS-1500 claim form accurately.
Ensure all details are correct to avoid denials or payment delays.
Double-check:
Payer name
Policy numbers
Diagnosis/procedure codes
Service dates and charges
Step 4: Reflection Questions (Separate Document)
After completing the claim, respond to the following in 4–6 sentences each in a separate Word document:
What key information was required for accurate claim creation?
How could missing or inaccurate claim data contribute to denials or payment delays?
How does claim accuracy support appeals and compliance processes in revenue cycle management?
Step 5: Save and Submit Your Work
Submit 2–3 screenshots that clearly show:
The completed CMS-1500 claim screen
Key populated data fields (patient, insurance, and services)
Confirmation or saved claim screen
Screenshots must demonstrate that you personally completed the EHRGo activity