CPB (Certified Professional Biller) Certification Practice Exam

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What type of claim is processed using the CMS-1500 form?

  1. Insurance claim used by noninstitutional providers

  2. Insurance claim used by institutional providers

  3. Medicare claim used by hospitals

  4. Medicaid claim used by pharmacies

The correct answer is: Insurance claim used by noninstitutional providers

The correct answer is A. The CMS-1500 form is used for processing insurance claims by noninstitutional providers such as physicians, nurse practitioners, and other healthcare professionals who bill for their services on a fee-for-service basis. This form is not typically used by institutional providers like hospitals, pharmacies, or for specific government programs like Medicare or Medicaid.