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of 29 available terms

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5 Written Questions

5 Matching Questions

  1. medical coder
  2. medical necessity
  3. health maintenance organization (HMO)
  4. capitation
  5. premium
  1. a a managed health care system in which provides agree to offer heath care to the organization's members for fixed periodic payments from paln
  2. b .a peson who analyzes and codes patient diagnoses, procedures, and symptoms
  3. c adavance payments to a provider that covers each plan member's health care services for a certain period of time
  4. d treament provided by a physycian to a patient for the purpose of preventing, diagnosing, or treating an illness, injury, or its symptoms in a manner that is appropriate and provided in accordance with generally accepted standards of medical practice.
  5. e the periodic amount of money the insured pays to a health plan for insurance coverage.

5 Multiple Choice Questions

  1. a type of managed care in which a high-deductible/low-premium insurance plan is combined with a pretax saving account to cover out-of-pocket medical expenses, up to the deductible limit
  2. regugular squedule of sending statements to patients
  3. .a person who buys an insurance plan; the insured
  4. process of assigning standardize codes to diagnises and procedures
  5. .managed care network of health care providers who agree to perform services for plan members at discounted fees

5 True/False Questions

  1. explanation of benefits (EOB)paper document form a payer that shows how the amount of a benefit was determined


  2. payerprivate or government organization that insures or pays for health care on the behalf of beneficiaries.


  3. accounting cyclethe flow of financial transactions in a bissiness


  4. diagnosisphysician's opinion of the nature of the patient's illness or injury


  5. procedurea code that identifies a medical service.


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