5 Written questions
5 Matching questions
- Encounter Form (Superbill)
- TRICARE-Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)
- Accounts Payable
- Preferred Provider Organization (PPO)
- a A request for payment.
- b 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.
- c The total amt. owed by the practice to suppliers and other service providers.
- d A printed form containing a list of the services with corresponding codes.
- e 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 Multiple choice questions
- The health care provider is automatically paid a fixed amt. per month regardless of provided services for each pt who is a member of a particular insurance organization.
- A prepaid group practice serving a secific geographic area.
- Insurance offered to all employees by and employer.
- A printed description of the benefits provided by the insurer to the beneficiary.
- The physician who admits a pt to the hospital (not necessarily the pt's attending physician)
5 True/False questions
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.
Utilization Management → A panel that tracks what their members receive and checks if their medical care meets the standards of the organization.
Coodination of Benefits (COB) → 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.
Member Physician → The physician who admits a pt to the hospital (not necessarily the pt's attending physician)
Third Party Payer → 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.