5 Written Questions
5 Matching Questions
- Accounts Receivable
- Attending Physician
- Accounts Payable
- a The physician who cares for a pt in the hospital (not necessarily the physician who admitted the pt)
- b The total amt. owed by the practice to suppliers and other service providers.
- c A predetermined amt. that the insured must pay each year before the insurance company will pay for an accident of illness.
- d The total amt. of all charges for services rendered to pt's that have not been paid to the physician.
- e Prior authorization must be obtained before the pt is admitted to the hospital or some specified outpatient or in-office procedures.
5 Multiple Choice Questions
- A condition that existed before the insured's policy was issued.
- 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.
- Private insurance to supplement Medicare benefits for noncovered services.
- Routine tests required for all pt's before hospital admission to screen for abnormal findings that could interfere with the pt's hospital stay or scheduled procedure.
- 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).
5 True/False Questions
Current Procedural Terminology Code (CPT) → 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).
Medicaid → A joint funding program by federal and state governments (excluding Arizona) for low-income pt's on public assistance for their medical care.
Fee Schedule → A list of approved professional services for which the insurance company will pay with the maximum fee paid for each service.
TRICARE-Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) → Established in 1973 for the spouses and dependent children of veterans who have total, permanent, service-connected disabilities.
Explanation of Benefits (EOB) → 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.