5 Written questions
5 Matching questions
- Accounts Receivable
- Preadmission Testing (PAT)
- Explanation of Benefits (EOB)
- Coodination of Benefits (COB)
- a A predetermined amt. that the insured must pay each year before the insurance company will pay for an accident of illness.
- b A printed description of the benefits provided by the insurer to the beneficiary.
- c 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.
- d Routine tests required for all pt's before hospital admission to screen for abnormal findings that could interfere with the pt's hospital stay or scheduled procedure.
- e The total amt. of all charges for services rendered to pt's that have not been paid to the physician.
5 Multiple choice questions
- A term given to a primary care physician for coodinating the pt's care to specialists, hospital admissions and so on.
- A list of approved professional services for which the insurance company will pay with the maximum fee paid for each service.
- The person who has been insured, and insurance policy holder.
- A condition that existed before the insured's policy was issued.
- 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.
5 True/False questions
Claim → A request for payment.
Coding → Transference of words into numbers to facilitate the use of computers in claim processing.
Internal Classification of Diseases, Revision, Clinical Modification (ICD) → A printed description of the benefits provided by the insurer to the beneficiary.
Current Procedural Terminology Code (CPT) → 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)
Medigap (Medifill) → A joint funding program by federal and state governments (excluding Arizona) for low-income pt's on public assistance for their medical care.