5 Written questions
5 Matching questions
- ALLOWED CHARGES
- ACCEPT ASSIGNMENT
- VALUE ADDED NETWORK (VAN)
- a the maximum amount the payer will reimburse for ecah procedure or service, according to the paitent's policy.
- b HOSPITAL TERM FOR ENCOUNTER FORM
- c CLEARINGHOUSE THAT INVOLVES VALUE ADDED VENDORS, SUCH AS BANKS, IN THE PROCESSING OF CLAIMS
- d Health Insurance Claim Form
- e The provider agrees to accept what the insurance company approves as payment in full for the claim.
5 Multiple choice questions
- EDI - COMPUTER TO COMPUTER EXCHANGE OF DATA BETW. PROVIDER AND PAYER
- 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.
- COMPLETE FINANCIAL RECORD OF INDIVIDUAL PATIENT
- PARTICIPATING PROVIDER
- The health plan that pays benefits first when a patient is covered by more than one plan.
5 True/False questions
GENDER RULE → THE FATHERS PLAN IS ALWAYS PRIMARY WHEN A CHILD IS COVERED BY BOTH PARENTS
APPEAL → DOCUMENTED AS A LETTER, SIGNED BY PROVIDER EXPLAINING WHY A CLAIM SHOULD BE RECONSIDRERED
UNBUNDLING → NON PARTICIPATING PROVIDER
ELECTRONIC FLAT FILE FORMAT → EDI - COMPUTER TO COMPUTER EXCHANGE OF DATA BETW. PROVIDER AND PAYER
SOF → SIGNATURE ON FILE