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5 Written questions

5 Matching questions

  1. GENDER RULE
  2. BIRTHDAY RULE
  3. CLEARINGHOUSE
  4. PAR
  5. PRIMARY INSURANCE
  1. a THE FATHERS PLAN IS ALWAYS PRIMARY WHEN A CHILD IS COVERED BY BOTH PARENTS
  2. b PROVIDES CENTRALIZED CLAIMS PROCESSING FOR PROVIDERS AND HEALTH PLAN
  3. c The guideline that determines which of two parents with medical coverage has the primary insurance for a child; the parent whose day of birth is earlier in the calendar year is considered primary.
  4. d The health plan that pays benefits first when a patient is covered by more than one plan.
  5. e PARTICIPATING PROVIDER

5 Multiple choice questions

  1. PROFESSIONAL SVCS/TECHNICAL SVCS, MODIFIERS ADDED
  2. Health Insurance Claim Form
  3. FINANCIAL RECORD FOR INDIVIDUAL PATIENT THAT DAY
  4. ACCURATE CLAIM FORM
  5. DOCUMENTED AS A LETTER, SIGNED BY PROVIDER EXPLAINING WHY A CLAIM SHOULD BE RECONSIDRERED

5 True/False questions

  1. ELECTRONIC FLAT FILE FORMATEDI - COMPUTER TO COMPUTER EXCHANGE OF DATA BETW. PROVIDER AND PAYER

          

  2. VALUE ADDED NETWORK (VAN)the maximum amount the payer will reimburse for ecah procedure or service, according to the paitent's policy.

          

  3. GUARANTORPARTICIPATING PROVIDER

          

  4. ASSIGNMENT OF BENEFITSAn arrangement by which a patient requests that his or her health insurance benefit payments be made directly to a physician or hospital is called a(n):

          

  5. PATIENT LEDGER/PATIENT ACCOUNT RECORDESTABLISHED PATIENT