5 Written questions
5 Matching questions
- CMS 1500
- Preadmission Testing (PAT)
- Third Party Payer
- a A term given to a primary care physician for coodinating the pt's care to specialists, hospital admissions and so on.
- b 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.
- c Insurance Carrier.
- d The standard claim form
- e A predetermined amt. that the insured must pay each year before the insurance company will pay for an accident of illness.
5 Multiple choice questions
- A printed form containing a list of the services with corresponding codes.
- The total amt. of all charges for services rendered to pt's that have not been paid to the physician.
- The health care provider is automatically paid a fixed amt. per month regardless of provided services for each pt who is a member of a particular insurance organization.
- 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.
- The physician who admits a pt to the hospital (not necessarily the pt's attending physician)
5 True/False questions
Member Physician → A physician who has contacted to participate with an insurance company to be reimbursed for services according to the company's plan.
Managed Care → 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.
Walkout Statement → A printed form with the pt's charges and the amt. paid for the servces rendered, which the pt takes with her. (receipt)
Group Insurance → Insurance offered to all employees by and employer.
Copayment or Coinsurance → A specified amt. that the insured must pay toward the charge for professional services rendered.