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5 Written Questions

5 Matching Questions

  1. Precertification
  2. Accounts Receivable
  3. Attending Physician
  4. Accounts Payable
  5. Deductible
  1. a The physician who cares for a pt in the hospital (not necessarily the physician who admitted the pt)
  2. b The total amt. owed by the practice to suppliers and other service providers.
  3. c A predetermined amt. that the insured must pay each year before the insurance company will pay for an accident of illness.
  4. d The total amt. of all charges for services rendered to pt's that have not been paid to the physician.
  5. 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

  1. A condition that existed before the insured's policy was issued.
  2. 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.
  3. Private insurance to supplement Medicare benefits for noncovered services.
  4. 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.
  5. 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

  1. 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).

          

  2. MedicaidA joint funding program by federal and state governments (excluding Arizona) for low-income pt's on public assistance for their medical care.

          

  3. Fee ScheduleA list of approved professional services for which the insurance company will pay with the maximum fee paid for each service.

          

  4. 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.

          

  5. 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.

          

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