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5 Written questions

5 Matching questions

  1. Assignment of Benefits
  2. Medicaid
  3. Coding
  4. Precertification
  5. Managed Care
  1. a Transference of words into numbers to facilitate the use of computers in claim processing.
  2. b The authorized signature of the pt for payment to be paid directly to the physician for services.
  3. c A system of medical team members organized into groups to provide quality and cost-effective care that encompasses both the delivery of health care and payment of the services.
  4. d Prior authorization must be obtained before the pt is admitted to the hospital or some specified outpatient or in-office procedures.
  5. e A joint funding program by federal and state governments (excluding Arizona) for low-income pt's on public assistance for their medical care.

5 Multiple choice questions

  1. The total amt. owed by the practice to suppliers and other service providers.
  2. A predetermined amt. that the insured must pay each year before the insurance company will pay for an accident of illness.
  3. The physician who cares for a pt in the hospital (not necessarily the physician who admitted the pt)
  4. Established in 1973 for the spouses and dependent children of veterans who have total, permanent, service-connected disabilities.
  5. A list of approved professional services for which the insurance company will pay with the maximum fee paid for each service.

5 True/False questions

  1. Encounter Form (Superbill)A printed form containing a list of the services with corresponding codes.


  2. Utilization ReviewA 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.


  3. Member PhysicianThe physician who admits a pt to the hospital (not necessarily the pt's attending physician)


  4. 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.


  5. Internal Classification of Diseases, Revision, Clinical Modification (ICD)The coding system used to document diseases, injuries, illness and mortalities.