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5 Written questions

5 Matching questions

  1. CHARGEMASTER
  2. ALLOWED CHARGES
  3. CMS-1500
  4. ACCEPT ASSIGNMENT
  5. VALUE ADDED NETWORK (VAN)
  1. a the maximum amount the payer will reimburse for ecah procedure or service, according to the paitent's policy.
  2. b HOSPITAL TERM FOR ENCOUNTER FORM
  3. c CLEARINGHOUSE THAT INVOLVES VALUE ADDED VENDORS, SUCH AS BANKS, IN THE PROCESSING OF CLAIMS
  4. d Health Insurance Claim Form
  5. e The provider agrees to accept what the insurance company approves as payment in full for the claim.

5 Multiple choice questions

  1. EDI - COMPUTER TO COMPUTER EXCHANGE OF DATA BETW. PROVIDER AND PAYER
  2. 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.
  3. COMPLETE FINANCIAL RECORD OF INDIVIDUAL PATIENT
  4. PARTICIPATING PROVIDER
  5. The health plan that pays benefits first when a patient is covered by more than one plan.

5 True/False questions

  1. GENDER RULETHE FATHERS PLAN IS ALWAYS PRIMARY WHEN A CHILD IS COVERED BY BOTH PARENTS

          

  2. APPEALDOCUMENTED AS A LETTER, SIGNED BY PROVIDER EXPLAINING WHY A CLAIM SHOULD BE RECONSIDRERED

          

  3. UNBUNDLINGNON PARTICIPATING PROVIDER

          

  4. ELECTRONIC FLAT FILE FORMATEDI - COMPUTER TO COMPUTER EXCHANGE OF DATA BETW. PROVIDER AND PAYER

          

  5. SOFSIGNATURE ON FILE

          

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