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5 Written questions

5 Matching questions

  1. Workers Compensation
  2. Encounter Form (Superbill)
  3. Claim
  4. Subscriber
  5. Preexisting Condition
  1. a Government program that provides insurance coverage for those who are injured on the job or who have developed work related disorders, disabilities or illnesses.
  2. b A printed form containing a list of the services with corresponding codes.
  3. c A request for payment.
  4. d A condition that existed before the insured's policy was issued.
  5. e The person who has been insured, and insurance policy holder.

5 Multiple choice questions

  1. A panel that tracks what their members receive and checks if their medical care meets the standards of the organization.
  2. The total amt. of all charges for services rendered to pt's that have not been paid to the physician.
  3. A review carried out by allied health professionals at predetermined times to assess the necessity of the particular pt to remain in an acute care facility.
  4. Coding system published by the american medical association that translates services received by a pt into a numeric value for convenience and continiuity of reporting these services to third parties for payment. The system is recognized by governmental payers and private insurance companies. (*always 5 digits ex:25000)
  5. A medical facility that is licensed (as defined by Medicare) to primarily provide skilled nursing care to pt's.

5 True/False questions

  1. Group InsuranceInsurance offered to all employees by and employer.


  2. Copayment or CoinsuranceInsurance offered to all employees by and employer.


  3. Admitting PhysicianThe physician who cares for a pt in the hospital (not necessarily the physician who admitted the pt)


  4. Civilian Health and Medical Program of the Veterans' Administration (CHAMPVA)Established to aid dependents of active service personnel, retired servces personnel and their dependents, dependents of services personnel who died on active duty, with a supplement for medical care in military or public health service facilities.


  5. Assignment of BenefitsProcedures used by insurers to avoid ducplication of payment on claims when the pt has more than one policy. one insurance becomes the primary payer and no more than 100% of the costs are covered.


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