Certified Revenue Cycle Representative (CRCR) Practice Exam

What date is required on all CMS 1500 claim forms?

1. Patient's birth date

2. Last date of treatment

3. Onset date of current illness

4. Expiration date of insurance

The correct answer is: Onset date of current illness

The correct answer, which highlights the requirement for the CMS 1500 claim forms, is the onset date of the current illness. This date is crucial because it provides essential information that helps determine the duration and nature of the patient's medical condition as it relates to the claim. It allows payers to assess the appropriateness of the services billed and verifies the medical necessity in relation to the treatments provided. In the context of claims processing, the onset date can significantly influence claims adjudication, especially for certain types of insurance plans or services. It assists both the provider and the payer in evaluating the timeline of care and diagnosing relevant conditions, which is vital for accurate reimbursement. The other dates and information, while important in a clinical sense, do not hold the same significance in the context of the CMS 1500 form specifically. The patient's birth date is necessary for identification but does not directly relate to the services being billed. The last date of treatment can be relevant but is not uniformly required on every claim form. The expiration date of insurance is essential but pertains to coverage verification rather than billing specifics. Thus, the emphasis on the onset date of the current illness reflects its critical role in the claims process.