medical manager final

Terms in this set (60)

to keep the doctors books and tyhe patients ledger in balance any change in the original charge must be accounted for. a finished entry called an adjustment is used to increase or decrease the initial charge amount

a group of changes or payments posted in one session, or a group of insurance claims transmitted together electronically

this is the document sent to the insurance company to request payment for services that were performed for the patient

stands for current procedural terminology, a standard medical coding system developed by the american medical association

an end of day report detailing all of the transactions that were posted durning the day is also similar to a day sheet or daily log

is an accounting term thats means to increase an amount

this is the practice scheduling more patients than the physicians can see during a reasonable period of time

electronic media claims

this refers to electronic claims that are sent over the telephone, using a modem

a schedule of defined charges that a provider can use when billing

this is the person who agrees to be financially responbsible for the account

health maintenance organization

a group of physicians usually operating within one facility

international classification of diseases 9th edition published by the american medical association

insurance id number

an identification number is assigned by the insurance company to identify a particular insurance policy, also known as subscriber, policy #, id (insurance)#

major medical insurance

this is sometimes called catastrophe insurance because it is designed to help offset huge medical exspenses that result from a lengthy illness of serious accident

this is financial assistance program sponsored jointly by the federal government and the states to provide health care for the poor

this is an insurance program sposored by the federal government to protect the elderly and disabled population

this is a two digit code added to a procedure code including why the procedure is not being charged at its normal fee

a patient who receives in depth medical treatment, such as a surgical procedure, from a facility such as a hospital but not required to stay at the facility overnight

this is a unique number assigned to every patient at the time he or she is entered into the system during new patient entry

this is the individual who owns the insurance policy

an authorization form signed by the patient or official request from and authorized government agency to provide patient health information for purposes other than treatment, payment or official

two numeric characters that tell the company the type of bill a patient receives

a government insurance program for veterans and their dependents

the treatment or services the insurance plan will agree to allow for a patient

this is the amount the patient is expected to pay before the insurance plan will begin paying

a condition that prevents the patient from being able to perform certain activities

producing insurance claims electronically

a provider of services such as a laboratory or hospital

this is a field on the insurance policy screen that allows you to specify who the group policy belongs to

health insurance portability and accountability act

federal legislation intended to improve portability and continuity of health insurance coverage

a person who is required to stay at a facility overnight for in depth medical treatment

this is the person in whose name the insurance coverage is held

this is a term used to indicate that the treatment a physician provided to a patient was incorrect or improper

medicare adjustment

a medicare adjustment lowers the physicians charge to the amount that medicare approves

negative adjustment

this type of adjustment allows money that has been allocated to individual open itmes on a patients account to be removed from that item

this refers to charges that were posted previously but have not yet been paid in full or adjusted off the account

place of service, this is a series of standardized codes that indicate where the doctor saw the patient or performed the procedure

primary care physician

this is a doctor who has contracted with a managed care plan and has agreed to be responsible for providng the health care for specific patients participating in the plan

payment of a medical claim

responsible party

the person or the organization responsible for paying part or all of the patients bill

under hippa privacy rules, the patient give consent to the use of his or her protected health information by the medical practice for purposes of treatment

an accounting term that means to lower an amount

the physicians determination of what is wrong with each patient is called the diagnosis

explanation of benefits

this is an insurance company document that accompanies payment(or explains the lack of payment) for a particular patients charges

insurance claim

most people have health insurance that pays all or a portion of expsenses incurred when they have an illness or injury, an insurance claim form must be completed and filed with the insurance company before reimbursment will be made

medicare approved amount

the maximum amount that a medicare participating provider may collect for perfoming a procedure

text written by the physician about the patient that includes items such as patient history, subjective and objective findings, and recommendations

is the practice of scheduling more patients than the physician can see during a reasonable period of time

preferred provider organization

an organization of physicians participating in a plan. generally ppo plans allow the patient to see a participating physician or a nonparticipating physician of his or her choice

the service performed by the doctor

the services the doctor provides to a patient are called procedures and are indentified by a procedure code

any health care specialist rendering service

a government insurance program for military personnel and their dependents

this refers to the number of times the procedure was repeated durning the date or dates of service

the check or other type of payment that is used to pay an account

workers compensation

this is a insurance that covers medical expenses incurred as a result of work-related injury or disability

type of service

this is a series of standardized codes that indicate the type service performed for the patient (e.g..medical care, surgery)

bill sent by the doctor to each patient or family detailing the servies rendered

this is the date set within the medical manager system

this refers to a check that includes payment for more than one guarantors account

;