5 Written questions
5 Matching questions
- Coodination of Benefits (COB)
- Accounts Payable
- Internal Classification of Diseases, Revision, Clinical Modification (ICD)
- Group Insurance
- a The person who has been insured, and insurance policy holder.
- b Procedures used by insurers to avoid ducplication of payment on claims when the pt has more than one policy. one insurance becomes the primary payer and no more than 100% of the costs are covered.
- c The total amt. owed by the practice to suppliers and other service providers.
- d The coding system used to document diseases, injuries, illness and mortalities.
- e Insurance offered to all employees by and employer.
5 Multiple choice questions
- Insurance Carrier.
- Coding system published by the american medical association that translates services received by a pt into a numeric value for convenience and continiuity of reporting these services to third parties for payment. The system is recognized by governmental payers and private insurance companies. (*always 5 digits ex:25000)
- The total amt. of all charges for services rendered to pt's that have not been paid to the physician.
- A predetermined amt. that the insured must pay each year before the insurance company will pay for an accident of illness.
- The physician who cares for a pt in the hospital (not necessarily the physician who admitted the pt)
5 True/False questions
Admitting Physician → The physician who admits a pt to the hospital (not necessarily the pt's attending physician)
Explanation of Benefits (EOB) → A printed description of the benefits provided by the insurer to the beneficiary.
TRICARE-Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) → Established to aid dependents of active service personnel, retired servces personnel and their dependents, dependents of services personnel who died on active duty, with a supplement for medical care in military or public health service facilities.
Utilization Management → A review carried out by allied health professionals at predetermined times to assess the necessity of the particular pt to remain in an acute care facility.
Individual Insurance → Insurance offered to all employees by and employer.