Coding, Billing and insurance

63 terms by Treefrog10

Create a new folder

Advertisement Upgrade to remove ads

Final Exam

The medical office assistant might compile and record medical charts, reports, and correspondence.

True

HOPPA is an abbreviation for hospotal information per american medical association

False

Math skills are important when working with refunds and posting of payments.

True

Coding accuracy is very inportent to healthcare organizations because funding cannot be recieved without accurate coding

True

What job description requires escellent data entry dkills , math skills and a good working knowledge of insurance contracts?

payment poster

a medical collector will contact most patients by

Telephone

a refund specialist position requires ______and _____

researching and analytical skills

the knowledge of _____and ______ in imperitave to perform well in all medical administrative positions

coding and billing

coinsurance is paid by the provider

...

the deductivle is the amount the insured must pay for each healthcare encounter sugh as an office visit

...

A policyholder is a person who buys an insurance plan.

...

The role of a PCP is to coordinate a patients overall care.

...

One incentive for an insured to use a network provider is reduced out of pocket costs.

...

Under an indemnity plan, a patient may use the services of ____________

...

A policyholder's _____ includes the spouse and children.

...

______ plans are regulated by the Employee Retirement Income Security act. (ERISA)

...

The ____ is the percentage of each claim that the insured must pay.

...

In managed care, patients often pay a specified amount called a _______ for an office visit to a provider.

...

A member of an HMO must get a _____from the PCP before seeing a specialist.

...

A capitated payment is prepaid to a provider to cover a plan member's health services for a specified period.

...

The amount that an insured person must pay for each office visit is call the co-payment.

...

Ethics are standards of behavior for licensed medical staff an other employees of medical practices.

...

A patients bill of rights consists of this principle____.

...

COB is defined as _______.

...

The list of medical services covered the insureds' policy is called ______.

...

The term medically necessary refers to the use of services or supplies or both as determined by the corporation medical director or his designee that ________.

...

A sudden flare up of a patient's chronic condition may be characterized as acute.

True

The alphabetic index of the ICD 9 is used first which locating a diagnostic code.

True

A coexisting condition is reported when it effects the patients primary condition or is also treated during an encounter.

True

The etiology is the origin or cause of a disease.

Tru

A late effect occurs some period of time after the acute disease is resolved.

True

In the ICD9 NOS or not otherwise specified indicates a code to be used when too little info is available to assign another more specific code.

True

Sub-terms appear below the main term in the ICD9 alphabetic index

True

The ICD9 diagnotic codes are made of either 3, 4, or 5 digits and a description.

True

Codes in the tabular list of the ICD9 are organized according to anatomic system or cause.

True

In the ICD9 () are used around descriptions that are not essential parts of a term.

True

The alphbetic index of the ICD 9 can be used alone to correctly locate a diagnostic code.

False

Signs and Symptoms are reported when a patients condition has not been diagnosed.

True

An annual preventive vaccination is reported using a "V" code from the ICD9

True

A disease or procedure that is named for a person is an_______

EPONYM

A person history of cancer is reported with a _____.

"V"code

An annual checkup is classified with a

"V" code

The statement "patient has a famiily history of breast cancer" requires a _______

V code

A physicians description of the main reason for a patients encounter is call the diagnostic______

statement

When diagnostic codes are reported, the code for the ______diagnosis is listed first followed by the current co-existing condition.

primary

The patient is the insured person, the "self" entry is marked under the patient relationship to the insured on the CMD 1500 claim form.

True

If the patient has addition insurance through a spounse, this information must be provided onthe CMS 1500 claim form.

True

The birthday rule states that the patient whose day of birth is earlier in the calender year will be considered the primary insurer.

True

HIPAA develops standards and regulations to be used by all providers carriers, billing services and clearing houses in order to _______.

...

The intermediary is a company that is paid to process claims for Medicare Part A.

...

Medicare covers an anual physical examination.

...

Under the Medicare program non participating non accepting assignment physician may not bill morethan 115% of _______

...

When a patient is over age 65 and employed the employees group health plain, not medicare is the _________plan.

primary

What does CMS mean?

...

Accounts Receivable include money owed the practice by the payers and patients.

...

An adjustment is a negative or positive change to an acount balance.

...

The medicare allowed charge for a procedure is $80.00. what amount does a participating provider receive from Medicare and what amount from the patient?

$64/$16

The medicare allowed charge for a procedure is $150. A par providers usual charge is $200. What amount must the provider write off?

$50.00

The deductibles co insurance and co payments patients pay are called ____________

Out of Pocket expenses

Down coding is also called ________

...

Under the formula for calculating a medicare fee for a procedure, the sum of adjusted totals for work, practice expense, and malpractice are multiplied by a _______

...

Medical insurance plans require patients to pay for all ________services.

...

If a carrier has continued to deny all the practices appeal requests, the provider can file a request to the ______for assistance.

...

Please allow access to your computer’s microphone to use Voice Recording.

Having trouble? Click here for help.

We can’t access your microphone!

Click the icon above to update your browser permissions above and try again

Example:

Reload the page to try again!

Reload

Press Cmd-0 to reset your zoom

Press Ctrl-0 to reset your zoom

It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.

Please upgrade Flash or install Chrome
to use Voice Recording.

For more help, see our troubleshooting page.

Your microphone is muted

For help fixing this issue, see this FAQ.

Star this term

You can study starred terms together

NEW! Voice Recording

Create Set