← Medical Billing and Coding - week 1 Export Options Alphabetize Word-Def Delimiter Tab Comma Custom Def-Word Delimiter New Line Semicolon Custom Data Copy and paste the text below. It is read-only. Select All AAPC American Academy of Professional Coders - offers 4 certification exams. CPCA (The Certified Professional Coder Apprentice), CPC-HA (Certified Professional Coder - Hospital Apprentice) , CPC (Certified Professional Coder), and CPC-H (Certified Professional Coder - Hospital) AHIMA American Health Information Management Association - supports 3 certification exams for coding specialists - CCA (Certificed Coding Associate), fulfills the need for an entry-level coding credential, CCS - (Certified Coding Specialist), demonstrates competence in ICD-9-CM and CPT Surgery coding, as well as in patient documentation and data integrity/quality issues, anatomy, physiology, and pharmacology, CCS-P (Certified Coding Specialist - Physician Based, demonstrates expertise in multispecialty CPt, ICD-9-CM, and HCPCS national (level II coding). AMBA American Medical Billing Association - offers the Certified Medical Reimbursent Specialist (CMRS) exam bonding insurance An insurance agreement that guarantees repayment for financial losses resulting from an employee's act or failure to act. It protects the financial operations of the employer. CMS Centers for Medicare and Medicaid Services - the administration agency within the federal Department of Health and Human Services. coding The process of reporting diagnoses, procedures, and services as numeric and alphanumeric characters on the insurance claim. Two systems used are ICD-9CM and HCPCS. CPT Current Procedural Terminology electronic claims processing Send data in a standardized machine-readable format to an insurance company via disk, telephone modem or cable. EDI Electronic Data Interchange - The mutual exchange of data between the provider and the insurance company, and is often used in clearinghouses. embezzle steal errors and omissions insurance Provides protection from claims resulting in errors and omissions associated with professional services provided to clients as expected of a person in the contractor's profession. ethics The principles of right or good conduct, and rules that govern the conduct of members of a profession. EOB Explanation of benefits - A report that details the results of processing a claim. HCPCS Healthcare Common Procedure Coding System health care provider A physician or other health care practioner (e.g., physician's assistant). health information technician Manage patient health information and medical records, administer computer information systems, and code diagnoses and procedures for health care services provided to patients. health insurance claim Documentation submitted to an insurance plan requesting reimbursement for health care services provided. health insurance specialist Review health-related claims to determine the medical necessity for procedures or services performed before payment (reimbursement) is made to the provider. hold harmless clause Patient is not responsible for paying what the insurance plan denies in the contract, the health care provider cannot collect the fees from the patient. independent contractor A person who performs services for another under an express or implied agreement and who is not subject to the others' control, or right to control, of the manner and means of performing the services. ICD-9-CM International Classification of Disease - 9th Revision, Clinical Modification liability insurance Protects business assets and covers the cost of lawsuits resulting from bodily injury (e.g., customer slips on wet floor), personal injury (e.g. slander or libel), and false advertising. medical malpractice insurance A type of liability insurance, which covers physicians and other health care professionals for liability as to claims arising from patient treatment. medical necessity Linking every procedure or service code reported on the claim to a condition code that justifies the necessity for performing that procedure or service. national codes (level II codes) Commonly referred to as HCPCS level II codes, which are published by CMS and include five-digit alphanumeric codes for procedures, services, and supplies that are not classified in CPT. NEBA National Electronic Billers Alliance preauthorization Prior approval for treatment of specialists and post-treatment reports. professional liability insurance Provides protection from claims resulting from errors and omissions associated with professional services provided to clients as expected of a person in the contractor's profession. property insurance Protects business contents against fire, theft, and other risks. reimbursement specialist Review health-related claims to determine the medical necessity for procedures or services performed before payment (reimbursement) is made to the provider. remittance advice (remit) A notice sent by the insurance company that consists of payment information about a claim. respondeat superior Means that the employer is liable for the actions and omissions of employees as performed and committed within the scope of their employment. scope of practice Defines the profession, delineates qualifications and responsibilities, and clarifies supervision requirements. workers' compensation insurance Protection mandated by state law that covers employees and their dependents against injury and death occurring during the course of employment.