5 Written Questions
5 Matching Questions
- Accounts Receivable
- Managed Care
- TRICARE-Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)
- a A system of medical team members organized into groups to provide quality and cost-effective care that encompasses both the delivery of health care and payment of the services.
- b The total amt. of all charges for services rendered to pt's that have not been paid to the physician.
- c Prior authorization must be obtained before the pt is admitted to the hospital or some specified outpatient or in-office procedures.
- d 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.
- e A term given to a primary care physician for coodinating the pt's care to specialists, hospital admissions and so on.
5 Multiple Choice Questions
- Insurance Carrier.
- A prepaid group practice serving a secific geographic area.
- This plan offers different insurance coverage depending on whether the pt receives services from a contracting network or non-network physician. The benefits are higher if the physician provider is a member of the PPO (or is a network physician).
- 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)
- 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.
5 True/False Questions
Encounter Form (Superbill) → A printed form containing a list of the services with corresponding codes.
Skilled Nursing Facility → The physician who cares for a pt in the hospital (not necessarily the physician who admitted the pt)
Deductible → A predetermined amt. that the insured must pay each year before the insurance company will pay for an accident of illness.
Walkout Statement → A printed form with the pt's charges and the amt. paid for the servces rendered, which the pt takes with her. (receipt)
Attending Physician → The physician who cares for a pt in the hospital (not necessarily the physician who admitted the pt)