5 Written questions
5 Matching questions
- Workers Compensation
- Encounter Form (Superbill)
- Preexisting Condition
- 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.
- b A printed form containing a list of the services with corresponding codes.
- c A request for payment.
- d A condition that existed before the insured's policy was issued.
- e The person who has been insured, and insurance policy holder.
5 Multiple choice questions
- A panel that tracks what their members receive and checks if their medical care meets the standards of the organization.
- The total amt. of all charges for services rendered to pt's that have not been paid to the physician.
- 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.
- 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 medical facility that is licensed (as defined by Medicare) to primarily provide skilled nursing care to pt's.
5 True/False questions
Group Insurance → Insurance offered to all employees by and employer.
Copayment or Coinsurance → Insurance offered to all employees by and employer.
Admitting Physician → The physician who cares for a pt in the hospital (not necessarily the physician who admitted the pt)
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.
Assignment of Benefits → Procedures 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.