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5 Written questions

5 Matching questions

  1. Coodination of Benefits (COB)
  2. Subscriber
  3. Accounts Payable
  4. Internal Classification of Diseases, Revision, Clinical Modification (ICD)
  5. Group Insurance
  1. a The person who has been insured, and insurance policy holder.
  2. 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.
  3. c The total amt. owed by the practice to suppliers and other service providers.
  4. d The coding system used to document diseases, injuries, illness and mortalities.
  5. e Insurance offered to all employees by and employer.

5 Multiple choice questions

  1. Insurance Carrier.
  2. 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)
  3. The total amt. of all charges for services rendered to pt's that have not been paid to the physician.
  4. A predetermined amt. that the insured must pay each year before the insurance company will pay for an accident of illness.
  5. The physician who cares for a pt in the hospital (not necessarily the physician who admitted the pt)

5 True/False questions

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


  2. Explanation of Benefits (EOB)A printed description of the benefits provided by the insurer to the beneficiary.


  3. 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.


  4. Utilization ManagementA 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.


  5. Individual InsuranceInsurance offered to all employees by and employer.