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Study sets matching "insurance handbook for the medical office"

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Study sets matching "insurance handbook for the medical office"

36 terms
Insurance Handbook For The Medical Office
A/an_______ is a legally enforceable a…
An individual promising to pay for med…
List five health insureance policy ren…
Insurance reimbursement or payment is…
insurance contract policy
guarantor or subcriber
a. Canceable... b. Optionally renewable... c.Condtionally renewable…
Indemnity
A/an_______ is a legally enforceable a…
insurance contract policy
An individual promising to pay for med…
guarantor or subcriber
9 terms
Insurance Handbook for the Medical Office
HIPAA
MSOs
MSHP
NPP
Health Insurance Portability and Accountability Act
Management Service Organizations
MultiSkilled Health Practitioners
Non Physician Practitioners
HIPAA
Health Insurance Portability and Accountability Act
MSOs
Management Service Organizations
36 terms
Insurance Handbook For The Medical Office
A/an_______ is a legally enforceable a…
An individual promising to pay for med…
List five health insureance policy ren…
Insurance reimbursement or payment is…
insurance contract policy
guarantor or subcriber
a. Canceable... b. Optionally renewable... c.Condtionally renewable…
Indemnity
A/an_______ is a legally enforceable a…
insurance contract policy
An individual promising to pay for med…
guarantor or subcriber
40 terms
Insurance Handbook for the Medical Office
American Health Information Management…
All of the Above - knowledge, experien…
All of the Above- holding patients' me…
consideration for others
Which organization published diagnostic and procedure coding…
The amount of money an insurance billing specialist earns is…
a billing specialist is entrusted with
Medical etiquette refers to
American Health Information Management…
Which organization published diagnostic and procedure coding…
All of the Above - knowledge, experien…
The amount of money an insurance billing specialist earns is…
Insurance Handbook For The Medical Office
A/an_______ is a legally enforceable a…
An individual promising to pay for med…
List five health insureance policy ren…
Insurance reimbursement or payment is…
insurance contract policy
guarantor or subcriber
a. Canceable... b. Optionally renewable... c.Condtionally renewable…
Indemnity
A/an_______ is a legally enforceable a…
insurance contract policy
An individual promising to pay for med…
guarantor or subcriber
37 terms
Insurance Handbook For The Medical Office
A/an_______ is a legally enforceable a…
An individual promising to pay for med…
List five health insureance policy ren…
Insurance reimbursement or payment is…
insurance contract policy
guarantor or subcriber
a. Canceable... b. Optionally renewable... c.Condtionally renewable…
Indemnity
A/an_______ is a legally enforceable a…
insurance contract policy
An individual promising to pay for med…
guarantor or subcriber
36 terms
Insurance Handbook For The Medical Office
A/an_______ is a legally enforceable a…
An individual promising to pay for med…
List five health insureance policy ren…
Insurance reimbursement or payment is…
insurance contract policy
guarantor or subcriber
a. Canceable... b. Optionally renewable... c.Condtionally renewab…
Indemnity
A/an_______ is a legally enforceable a…
insurance contract policy
An individual promising to pay for med…
guarantor or subcriber
40 terms
Insurance Handbook for the Medical Office
American Health Information Management…
All of the Above - knowledge, experien…
All of the Above- holding patients' me…
consideration for others
Which organization published diagnostic and procedure coding…
The amount of money an insurance billing specialist earns is…
a billing specialist is entrusted with
Medical etiquette refers to
American Health Information Management…
Which organization published diagnostic and procedure coding…
All of the Above - knowledge, experien…
The amount of money an insurance billing specialist earns is…
40 terms
Insurance Handbook for the Medical Office
American Health Information Management…
All of the Above - knowledge, experien…
All of the Above- holding patients' me…
consideration for others
Which organization published diagnostic and procedure coding…
The amount of money an insurance billing specialist earns is…
a billing specialist is entrusted with
Medical etiquette refers to
American Health Information Management…
Which organization published diagnostic and procedure coding…
All of the Above - knowledge, experien…
The amount of money an insurance billing specialist earns is…
Insurance Handbook for the Medical Office (ch2)
Compliance is the process of
Transactions in which health care info…
Baby Nelson was born on January 20, 20…
A code system used for managing patien…
Meeting regulations, recommendations, and expectations of fed…
e-health information management and its acronym is eHIM
201201200715 YYYMMDDHHMM
Systematized Nomenclature of Human & Veterinary Medicine its…
Compliance is the process of
Meeting regulations, recommendations, and expectations of fed…
Transactions in which health care info…
e-health information management and its acronym is eHIM
72 terms
Insurance Handbook for the Medical Office Ch. 13 & 14
When did federal participation in prov…
Which act set up the public assistance…
In 1950 Congress passed a law mandatin…
As a result of Congress' mandate, what…
between 1933 and 1935 when the Emergency Relief Administratio…
the Social Security Act of 1935
that all states set up a health care program of assistance (m…
the states set up Medicaid (MCD) programs.
When did federal participation in prov…
between 1933 and 1935 when the Emergency Relief Administratio…
Which act set up the public assistance…
the Social Security Act of 1935
47 terms
Insurance handbook for the Medical Office Ch. 8
Accredited Standards Committee X12 (AS…
Accredited Standards Committee X12 Ver…
Application Service Provider
Back Up
The U.S. standards body formed by the American National Stand…
Upgrade transaction standards that allows providers and payer…
A practice management system available over the Internet in w…
A duplicate data file, such as tape, CD-ROM, disk, or zip dis…
Accredited Standards Committee X12 (AS…
The U.S. standards body formed by the American National Stand…
Accredited Standards Committee X12 Ver…
Upgrade transaction standards that allows providers and payer…
59 terms
Insurance Handbook for the Medical Office Chapter 4
Emergency care is usually given to chr…
A permanent, legal document that forma…
A child's health record is no longer n…
The name of a disease, anatomic struct…
False
Medical Report
False
Eponym
Emergency care is usually given to chr…
False
A permanent, legal document that forma…
Medical Report
72 terms
Insurance Handbook for the Medical Office Ch. 13 & 14
When did federal participation in prov…
Which act set up the public assistance…
In 1950 Congress passed a law mandatin…
As a result of Congress' mandate, what…
between 1933 and 1935 when the Emergency Relief Administratio…
the Social Security Act of 1935
that all states set up a health care program of assistance (m…
the states set up Medicaid (MCD) programs.
When did federal participation in prov…
between 1933 and 1935 when the Emergency Relief Administratio…
Which act set up the public assistance…
the Social Security Act of 1935
59 terms
Insurance handbook for the medical office chp 14 workbook
History of TRICARE
CHAMPUS was created to
CHAMPUS Prime
What are the three regions of TRICARE…
1. 1966 CHAMPUS created (Civilian Health and Medical Program…
fund comprehensive health benefits for military members and f…
, a managed care plan, was created to control escalating medi…
Region West, Region North, Region South)
History of TRICARE
1. 1966 CHAMPUS created (Civilian Health and Medical Program…
CHAMPUS was created to
fund comprehensive health benefits for military members and f…
8 terms
Chapter 12 (Medicare) Insurance Handbook for Medical Office
An individual becomes eligible for Med…
Medicare Part A is ________coverage, a…
Name an eligibility requirement that w…
Funding for the Medicare Part A progra…
65 Yrs of age
hospital coverage, outpatient coverage
They would have to live in the United States for 5 yrs
Contributions from employees and self-employees
An individual becomes eligible for Med…
65 Yrs of age
Medicare Part A is ________coverage, a…
hospital coverage, outpatient coverage
28 terms
Ch. 10 Insurance Handbook for the Medical Office
Third-party payers are composed of
The unpaid balance due from patients f…
An important document that provides de…
A term preferable to "write-off" when…
a. private insurance... b. government plans... c. managed care cont…
Account receivable
patient registration form or patient information sheet.
courtesy adjustment.
Third-party payers are composed of
a. private insurance... b. government plans... c. managed care cont…
The unpaid balance due from patients f…
Account receivable
24 terms
Insurance Handbook For The Medical Office: Chapter 11
capitation.
closed panel
gatekeeper
a. managed care organizations (MCOs).…
If a physician or hospital in a managed care plan is paid a f…
When a prepaid group practice plan limits the patient's choic…
In a managed care setting, a physician who controls patient a…
Systems that allow for better negotiations for contracts with…
capitation.
If a physician or hospital in a managed care plan is paid a f…
closed panel
When a prepaid group practice plan limits the patient's choic…
72 terms
Insurance Handbook for the Medical Office Ch. 13 & 14
When did federal participation in prov…
Which act set up the public assistance…
In 1950 Congress passed a law mandatin…
As a result of Congress' mandate, what…
between 1933 and 1935 when the Emergency Relief Administratio…
the Social Security Act of 1935
that all states set up a health care program of assistance (m…
the states set up Medicaid (MCD) programs.
When did federal participation in prov…
between 1933 and 1935 when the Emergency Relief Administratio…
Which act set up the public assistance…
the Social Security Act of 1935
22 terms
Insurance handbook for medical office chapter 1
embezzlement
fraud
abuse
up coding
a willful act by an employee of taking possession of an emplo…
can occur when deception is used in a claim submission to obt…
incidents or practices by physicians, not usually considered…
deliberate manipulation of cpt codes for increased payment
embezzlement
a willful act by an employee of taking possession of an emplo…
fraud
can occur when deception is used in a claim submission to obt…
47 terms
Insurance handbook for the Medical Office Ch. 8
Accredited Standards Committee X12 (AS…
Accredited Standards Committee X12 Ver…
Application Service Provider
Back Up
The U.S. standards body formed by the American National Stand…
Upgrade transaction standards that allows providers and payer…
A practice management system available over the Internet in w…
A duplicate data file, such as tape, CD-ROM, disk, or zip dis…
Accredited Standards Committee X12 (AS…
The U.S. standards body formed by the American National Stand…
Accredited Standards Committee X12 Ver…
Upgrade transaction standards that allows providers and payer…
24 terms
Chapter 16 - Insurance Handbook of the Medical Office
Disability income policies do not prov…
Disability income insurance provides b…
For patients receiving VA medical care…
In 1956, Congress established a progra…
True
False
True
Social Security Disability Insurance (SSDI)
Disability income policies do not prov…
True
Disability income insurance provides b…
False
80 terms
Insurance Handbook for the Medical office Ch.1 thru 3
What are the two main billing types?
Facility Billing
Professional Billing
Non Physician Providers
Facility and professional
hospitals, acute care hospitals, skilled nursing or long term…
is done for physicians or non-physician practioners(NPP)
provider who hasn't obtained a medical degree and can prescri…
What are the two main billing types?
Facility and professional
Facility Billing
hospitals, acute care hospitals, skilled nursing or long term…
14 terms
Ch. 10 Insurance Handbook for the Medical Office 13th Edition
discounts
dun message
debit card
debtor
reductions of the normal fee based on a specific amount of mo…
phrase to remind a patient about a delinquent account
item that permits bank customers to withdraw cash at any hour…
individual owing money
discounts
reductions of the normal fee based on a specific amount of mo…
dun message
phrase to remind a patient about a delinquent account
24 terms
insurance handbook for the medical office quiz 1 (ch1)
Electronic Claims Processor
Name some facilities where facility bi…
Name some examples of NPP's (non-physi…
Identify 3 career opportunities (job t…
The ability to input data, transmit insurance claims, update…
a) hospitals... b) Acute care hospitals... c) Skilled nursing or lo…
a) Physician assistant... b) Nurse practitioner... c) Advanced regi…
a) Insurance billing specialist... b) Coding specialist... c) Elect…
Electronic Claims Processor
The ability to input data, transmit insurance claims, update…
Name some facilities where facility bi…
a) hospitals... b) Acute care hospitals... c) Skilled nursing or lo…
17 terms
Chapter 2: Insurance Handbook for the Medical Office 13th Edition Workbook
19. One of the agencies charged with e…
20. HIPAA transaction standards apply…
21. Enforcement of the privacy standar…
22. Verbal or written agreement that g…
B. Office of Inspector General (OIG)
D. All of the above
C. Office of Civil Rights (OCR)
B. Consent
19. One of the agencies charged with e…
B. Office of Inspector General (OIG)
20. HIPAA transaction standards apply…
D. All of the above
8 terms
Insurance Handbook for the Medical Office-Chapter 3: Study Guide True/False
The Patient Protection and Affordable…
The Supreme Court deemed the Affordabl…
Health Benefit Exchanges will make the…
A subscriber of an insurance policy ma…
True
False
False
True
The Patient Protection and Affordable…
True
The Supreme Court deemed the Affordabl…
False
26 terms
Insurance Handbook for the medical office, Fordney, Chapter 9 & 10 Review
Accounts receivable are usually aged i…
Under federal regulations, a list of t…
A patient has a $600 balance and agree…
All collection calls should be placed:
30, 60, 90, and 120 days.
True
True
After 8 AM and before 9 PM.
Accounts receivable are usually aged i…
30, 60, 90, and 120 days.
Under federal regulations, a list of t…
True
25 terms
Insurance Handbook for the Medical Office-Chapter 3: Study Guide Multiple Choice
Which statement regarding the insuranc…
Most legal issues of private health in…
When does the physician/patient contra…
Most physician/patient contracts are...
The insurance industry is among the world's largest businesses.
Civil Law
When the physician accepts the patient and agrees to treat th…
Implied
Which statement regarding the insuranc…
The insurance industry is among the world's largest businesses.
Most legal issues of private health in…
Civil Law
9 terms
Chapter Four: Insurance Handbook for the Medical Office 13th edition Workbook
Attending Physician
Consulting Physician
Non-physician Practitioner
Ordering Physician
Legally responsible for the care and treatment given to a pat…
Directs selection, preparation, and administration of tests,…
Clinical nurse specialist or licensed social worker who treat…
Gives an opinion regarding a specific problem that is request…
Attending Physician
Legally responsible for the care and treatment given to a pat…
Consulting Physician
Directs selection, preparation, and administration of tests,…
73 terms
Insurance Handbook for the Medical Office Abbreviations Chapters 1, 2 & 3
AAMA
ACA
AHIMA
AMA
American Association of Medical Assistants
American Collectors Association
American Health Information Management Association
American Medical Association
AAMA
American Association of Medical Assistants
ACA
American Collectors Association
17 terms
Chapter 2: Insurance Handbook for the Medical Office 13th Edition Workbook
19. One of the agencies charged with e…
20. HIPAA transaction standards apply…
21. Enforcement of the privacy standar…
22. Verbal or written agreement that g…
B. Office of Inspector General (OIG)
D. All of the above
C. Office of Civil Rights (OCR)
B. Consent
19. One of the agencies charged with e…
B. Office of Inspector General (OIG)
20. HIPAA transaction standards apply…
D. All of the above
20 terms
Insurance Handbook for the Medical Office: Chapter 12 - Medicare (Multiple Choice Only)
Medicare Part A is run by...
Medicare is a ____ health insurance pr…
The letters preceding the number on th…
Currently the Part B Medicare annual d…
c: the Centers for Medicare and Medicaid Services
b: Federal
c: railroad retiree
b: $147
Medicare Part A is run by...
c: the Centers for Medicare and Medicaid Services
Medicare is a ____ health insurance pr…
b: Federal
73 terms
Insurance Handbook for the Medical Office Abbreviations Chapters 1, 2 & 3
AAMA
ACA
AHIMA
AMA
American Association of Medical Assistants
American Collectors Association
American Health Information Management Association
American Medical Association
AAMA
American Association of Medical Assistants
ACA
American Collectors Association
79 terms
Insurance Handbook for the Medical Office Review Ch.2-Ch.9
Fraud
Clearinghouse
Breach of confidential communication
Disclosure
an intentional misrepresentation of the facts to deceive or m…
a third-party administrator who receives insurance claims fro…
unauthorized release of patient's health information
give, release, or transfer of information to another entity
Fraud
an intentional misrepresentation of the facts to deceive or m…
Clearinghouse
a third-party administrator who receives insurance claims fro…
6 terms
Chapter 1: Insurance Handbook for the Medical Office 13th Edition
The ability to input data and transmit…
Name some of the facilities where faci…
Name examples of non-physician practit…
Identify three career opportunities (j…
Electronic Claims Processor
a. Hospitals... b. Acute Care Hospitals... c. Skilled Nursing or Lo…
a. Physician Assistant... b. Nurse Practitioner... c. Advanced Regi…
a. Insurance Billing... b. Electronic Claims Processor... c. Medica…
The ability to input data and transmit…
Electronic Claims Processor
Name some of the facilities where faci…
a. Hospitals... b. Acute Care Hospitals... c. Skilled Nursing or Lo…
30 terms
Exam 3 HIM 181 CIMO & Insurance Handbook for the Medical Office
Provider Selection Box
Patient Information
Calendar
Medisoft
In which of the four main areas of Office Hours is the provid…
In which of the main four areas of Office Hours does informat…
In which of the main four areas of Office Hours can dates be…
If Office Hours is started from within Medisoft, exiting will…
Provider Selection Box
In which of the four main areas of Office Hours is the provid…
Patient Information
In which of the main four areas of Office Hours does informat…
insurance handbook for the medical office quiz 1 (ch1)
Electronic Claims Processor
Name some facilities where facility bi…
Name some examples of NPP's (non-physi…
Identify 3 career opportunities (job t…
The ability to input data, transmit insurance claims, update…
a) hospitals... b) Acute care hospitals... c) Skilled nursing or lo…
a) Physician assistant... b) Nurse practitioner... c) Advanced regi…
a) Insurance billing specialist... b) Coding specialist... c) Elect…
Electronic Claims Processor
The ability to input data, transmit insurance claims, update…
Name some facilities where facility bi…
a) hospitals... b) Acute care hospitals... c) Skilled nursing or lo…
24 terms
insurance handbook for the medical office quiz 1 (ch1)
Electronic Claims Processor
Name some facilities where facility bi…
Name some examples of NPP's (non-physi…
Identify 3 career opportunities (job t…
The ability to input data, transmit insurance claims, update…
a) hospitals... b) Acute care hospitals... c) Skilled nursing or lo…
a) Physician assistant... b) Nurse practitioner... c) Advanced regi…
a) Insurance billing specialist... b) Coding specialist... c) Elect…
Electronic Claims Processor
The ability to input data, transmit insurance claims, update…
Name some facilities where facility bi…
a) hospitals... b) Acute care hospitals... c) Skilled nursing or lo…
22 terms
Insurance Handbook for the Medical Office: Chapter 5-Diagnostic Coding Quiz
Proper coding can mean financial succe…
All diagnoses that affect the current…
It is possible for a primary diagnosis…
Coding from an out-of-date diagnostic…
True (p127)
True (p128)
True (p128)
True
Proper coding can mean financial succe…
True (p127)
All diagnoses that affect the current…
True (p128)
23 terms
Insurance Handbook for the Medical Office: Chapter 10 - Office and Insurance Collection Strategies (Multiple Choice Only)
Cash flow is the...
When insurance carriers do not pay cla…
What does the insurance billing specia…
The average amount of accounts receiva…
c: ongoing availability of cash in the medical practice
b: decreased cash flow
d: accounts receivable
a: 1.5-2
Cash flow is the...
c: ongoing availability of cash in the medical practice
When insurance carriers do not pay cla…
b: decreased cash flow
7 terms
Insurance Handbook for the Medical Office-Chapter 4: Study Guide True/False
During an audit, points are awarded wh…
Private insurance carriers have the ri…
A problem-focused examination is more…
An established patient is anyone who h…
True
True
False
False (within 3 years)
During an audit, points are awarded wh…
True
Private insurance carriers have the ri…
True
28 terms
Insurance Handbook for the Medical Office-Chapter 4: Study Guide Multiple Choice
The key to sustaining procedure and di…
An electronic medical report is a...
An advantage of electronic medical rec…
When each entry in the medical record…
supporting documentation in the electronic health record
permanent legal document and part of the health record
greater standardization in clinical medical terminology
clonning
The key to sustaining procedure and di…
supporting documentation in the electronic health record
An electronic medical report is a...
permanent legal document and part of the health record
31 terms
Insurance Handbook for the Medical Office Ch1:Role of an Insurance Billing Specialist 01/12/2016
Revenue
Cycle
Service to Patients
Facility billing
Regular income
regularly repeating set of events that produce it
gives the opportunity to show high values, principles, and mo…
Facility billing is done for hospitals, acute care hospitals,…
Revenue
Regular income
Cycle
regularly repeating set of events that produce it
26 terms
Insurance Handbook for the Medical Office: Chapter 3 - Basics of Healthe Insurance (Multiple Choice Only)
Which statement is correct regarding t…
Most legal issues of private health in…
When does a physician/patient contract…
Most physician/patient contracts are...
b: the insurance industry is among the world's largest busine…
b:civil law
c: when the physician accepts the patient and agrees to treat…
a:implied
Which statement is correct regarding t…
b: the insurance industry is among the world's largest busine…
Most legal issues of private health in…
b:civil law
25 terms
Medical Insurance, and Medical Office
Point-of-Service
Benefit Period
Medicare A
Medicare B
allows beneficiaries to choose a provider that is or is not w…
A specified time during which benefits will be paid under cer…
benefits covering inpatient hospital and skilled nursing faci…
benefits covering outpatient hospital and health care provide…
Point-of-Service
allows beneficiaries to choose a provider that is or is not w…
Benefit Period
A specified time during which benefits will be paid under cer…
20 terms
Insurance Handbook for the Medical Office: Chapter 9 - Receiving Payments and Insurance Problem-Solving (Multiple Choice Only)
If a payment problem develops with an…
Pending or resubmitted insurance claim…
A follow-up effort made to an insuranc…
If an insurance claim has been lost by…
b: state insurance commissioner
a: tickler
d: (both a and b) inquiry/tracer
a: ask if there is a backlog of claims at the insurance office
If a payment problem develops with an…
b: state insurance commissioner
Pending or resubmitted insurance claim…
a: tickler
25 terms
Medical Insurance, and Medical Office
Point-of-Service
Benefit Period
Medicare A
Medicare B
allows beneficiaries to choose a provider that is or is not w…
A specified time during which benefits will be paid under cer…
benefits covering inpatient hospital and skilled nursing faci…
benefits covering outpatient hospital and health care provide…
Point-of-Service
allows beneficiaries to choose a provider that is or is not w…
Benefit Period
A specified time during which benefits will be paid under cer…
19 terms
Insurance Handbook for the Medical Office: Chapter 1 - Role of Insurance Specialist (Multiple Choice Only)
Cost pressures on health care provider…
A claims assistant professional:
What is "cash flow" in a medical pract…
Front office medical duties have becom…
c: multi-skilled health care practitioners
d: (both a and b) works for the consumer/helps patients file…
a: the actual money available to a medical practice
a: diagnostic and procedure coding must be reviewed for corre…
Cost pressures on health care provider…
c: multi-skilled health care practitioners
A claims assistant professional:
d: (both a and b) works for the consumer/helps patients file…
72 terms
Insurance Handbook for the Medical Office-key terms ch 3, 4, 5, 6, 7, 8
Accounts receivable management
Claim
Coinsurance
Coordination of Benefits
The organization and administration of coding and billing in…
A bill sent to an insurance carrier requesting payment for se…
A cost sharing requirement under a health insurance policy pr…
COB-Two insurance carriers working together and coordinating…
Accounts receivable management
The organization and administration of coding and billing in…
Claim
A bill sent to an insurance carrier requesting payment for se…
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