← Ch. 4 Insurance Test
5 Written Questions
5 Matching Questions
- VALUE ADDED NETWORK (VAN)
- ALLOWED CHARGES
- ELECTRONIC DATA INTERCHANGE
- a EDI - COMPUTER TO COMPUTER EXCHANGE OF DATA BETW. PROVIDER AND PAYER
- b the maximum amount the payer will reimburse for ecah procedure or service, according to the paitent's policy.
- c PARTICIPATING PROVIDER
- d SIGNATURE ON FILE
- e CLEARINGHOUSE THAT INVOLVES VALUE ADDED VENDORS, SUCH AS BANKS, IN THE PROCESSING OF CLAIMS
5 Multiple Choice Questions
- SERIES OF FIXED LENGTH RECORDS SUBMITTED TO PAYERS TO BILL FOR HEALTHCARE SVCS
- FINANCIAL RECORD FOR INDIVIDUAL PATIENT THAT DAY
- MEDICAL REPORT SUSTAINING A MEDICAL CONDITION
- HOSPITAL TERM FOR ENCOUNTER FORM
- 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.
5 True/False Questions
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.
PATIENT LEDGER/PATIENT ACCOUNT RECORD → COMPLETE FINANCIAL RECORD OF INDIVIDUAL PATIENT
PRIMARY INSURANCE → PROVIDES CENTRALIZED CLAIMS PROCESSING FOR PROVIDERS AND HEALTH PLAN
GUARANTOR → PERSON RESPONSIBLE FOR PAYING HEALTH CARE FEES