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CHI Chapter 11 (Week 4)
Terms in this set (15)
Billing system that groups patients bills according to the insurance policy holder
Define Assignments of Benefits form
Authorized by policyholder that allows a health plan to pay benefits directly to a provider
Define Release of Information form.
A claim can only be submitted to an insurance carrier on the patients behalf
How often should the medical office request that the patient sign and update a release of information form?
Once per year
Companies that functions as intermediaries who forward claims on the patients behalf
What is listed on and Audit-Edit report from a clearinghouse
Scrambling electronic information during transmission to prevent it from being intercepted
Pertaining to CSM-1500 form, what does the acronym OCR refer to?
Optical Character Recognition
Who issues the Employer Identification Number or federal tax ID number
The Internal Revenue Service (IRS)
What is the identification number issued to physicians who are authorized to practice medicine in a given state
State license number
Define Dirty Claim
If needed information is missing from a claim when it is submitted to an insurance carrier
Explain the Birthday rule.
If both parents cover a dependent then the dependent is covered under the parent whose birthday comes first
When will Coordination of benefits be used.
When the patient has more than one insurance plan
Define supplemental insurance
Who developed the CSM-1500 claim form?
Centers for Medicare and Medicaid Services
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