5 Written questions
5 Matching questions
- Assignment of Benefits
- Managed Care
- a Transference of words into numbers to facilitate the use of computers in claim processing.
- b The authorized signature of the pt for payment to be paid directly to the physician for services.
- 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.
- d Prior authorization must be obtained before the pt is admitted to the hospital or some specified outpatient or in-office procedures.
- 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
- The total amt. owed by the practice to suppliers and other service providers.
- 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)
- Established in 1973 for the spouses and dependent children of veterans who have total, permanent, service-connected disabilities.
- 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
Encounter Form (Superbill) → A printed form containing a list of the services with corresponding codes.
Utilization Review → 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.
Member Physician → The physician who admits a pt to the hospital (not necessarily the pt's attending physician)
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.
Internal Classification of Diseases, Revision, Clinical Modification (ICD) → The coding system used to document diseases, injuries, illness and mortalities.