5 Written questions
5 Matching questions
- CLAIMS ATTATCHMENT
- REPEAT PATIENT
- a ESTABLISHED PATIENT
- b Health Insurance Claim Form
- c NON PARTICIPATING PROVIDER
- d PERSON RESPONSIBLE FOR PAYING HEALTH CARE FEES
- e MEDICAL REPORT SUSTAINING A MEDICAL CONDITION
5 Multiple choice questions
- HOSPITAL TERM FOR ENCOUNTER FORM
- DOCUMENTED AS A LETTER, SIGNED BY PROVIDER EXPLAINING WHY A CLAIM SHOULD BE RECONSIDRERED
- EDI - COMPUTER TO COMPUTER EXCHANGE OF DATA BETW. PROVIDER AND PAYER
- the maximum amount the payer will reimburse for ecah procedure or service, according to the paitent's policy.
- PROFESSIONAL SVCS/TECHNICAL SVCS, MODIFIERS ADDED
5 True/False questions
PRIMARY INSURANCE → PROVIDES CENTRALIZED CLAIMS PROCESSING FOR PROVIDERS AND HEALTH PLAN
GENDER RULE → The guideline that determines which of two parents with medical coverage has the primary insurance for a child; the parent whose day of birth is earlier in the calendar year is considered primary.
ELECTRONIC FLAT FILE FORMAT → SERIES OF FIXED LENGTH RECORDS SUBMITTED TO PAYERS TO BILL FOR HEALTHCARE SVCS
UNBUNDLING → SUBMITTING MULTIPLE CPT CODES WHEN ONE SHOULD BE SUBMITTED
ACCEPT ASSIGNMENT → The provider agrees to accept what the insurance company approves as payment in full for the claim.