The claim process begins when:
The patient first contacts the office for an appointment
The health insurance professional should reverify patient information:
Each time the patient visits the office
A section included (often at the bottom of the form) for the patient to sign an:
Authorization to release information
Service that typically requires pre-certification includes:
The most important document in the medical insurance process is the:
Patient information form
The number that is assigned by the IRS and used as the employer indentifier standards for all electronic healthcare transactions is:
Employee indentification number (EIN)
After the claim has been received by a 3rd party payer, it is reviewed, and the carrier makes payment decision.
Document sent by the insurance carrier to the provider/patient explaining how the claim was adjudicated
Ideally, insurance claims should be submitted to the insurance carrier within:
If there is any question as to the limits for filing claims, the health insurance professional should contact the:
The insurance company who pays after the primary carrier is referred to as:
If there is a second insurance policy, it is important to check "yes" in:
A medicare review request for Part B appeals must come within:
Preauthorization or Precertification
Ultamatley, it is the patients responsibility to know when and how to notify the insurance comapny for _____ or _________
It is ______ the health insurance professional's responsibility to document the appropriate health-related comments in the patients health record.
Coding ________ and knowing which coding system payors use helps avoid payment errors on claims.
When a carrier assigns a substitute code because a claim was submitted with outdated, deleted or nonexistent CPT codes, is called: