Study sets matching "insurance medical coding management"

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Study sets matching "insurance medical coding management"

medical insurance billing and coding
english
billing codes
cpt codes
medical insurance
...
icd 10
cpt 9
health insurance today
english
...
billing codes
icd 10
Medical insurance \ medical insurance coding
Adjustment
Assignment of benefits
Beneficiary
Coordination of benefits cob
Increases or decreases to patient accounts not due to charges…
Signing over benefits by the beneficiary to another party
Person under a policy eligible to receive benefits
The provision of an insurance contract that limits benefits t…
Adjustment
Increases or decreases to patient accounts not due to charges…
Assignment of benefits
Signing over benefits by the beneficiary to another party
Medical Insurance/Medical Insurance Coding
Adjustment
Assignment of Benefits
Beneficiary
Coordination of Benefits (COB)
Increases/decreases to patient accounts not due to charges in…
Signing over of benefits by the beneficiary to another party
Person under a policy eligible to receive benefits
Provision of an insurance contract that limits benefits to 10…
Adjustment
Increases/decreases to patient accounts not due to charges in…
Assignment of Benefits
Signing over of benefits by the beneficiary to another party
28 terms
Medical Insurance/ Medical Insurance Coding
Adjustment
Assignment of benefits
Beneficiary
Coordinator of benefits (COB)
increases or decreases to patient accounts not due to charges…
signing over of benefits by the beneficiary to another party
person under a policy eligible to receive benefits
the provision of an insurance contract that limits benefits t…
Adjustment
increases or decreases to patient accounts not due to charges…
Assignment of benefits
signing over of benefits by the beneficiary to another party
27 terms
Medical Insurance Management - Chapter 18 Kinn's - Basics of Diagnostic Coding
abstract
Alphabetic Index
ancillary diagnostic services
and
an outline or summary of the diagnostic statement and/or proc…
Volume 2 of the ICD-9-CM coding manual; it lists conditions,…
Services that support patient diagnoses (e.g., laboratory or…
In the context of the ICD-9-CM, and should be interpreted as…
abstract
an outline or summary of the diagnostic statement and/or proc…
Alphabetic Index
Volume 2 of the ICD-9-CM coding manual; it lists conditions,…
26 terms
Medical insurance/ medical insurance coding
Adjustment
Assignment of benefits
Beneficiary
Coordination of benefits
Increase or decrease to patient accounts not due to charges i…
Signing over benefits by the beneficiary to another party
Person under a policy eligible to receive benefits
The provision of an insurance contract that limits benefits t…
Adjustment
Increase or decrease to patient accounts not due to charges i…
Assignment of benefits
Signing over benefits by the beneficiary to another party
Medical coding and insurance
Assignment of Insurance Benefits
Beneficiary
Birthday Rule
Capitation
A statement authorizing the insurance company to pay benefits…
The person receiving the benefits of an insurance policy
The rule governing the hierarchy of an insurance policy
A method of payment for health services in which an individua…
Assignment of Insurance Benefits
A statement authorizing the insurance company to pay benefits…
Beneficiary
The person receiving the benefits of an insurance policy
124 terms
MA - Medical Insurance & Coding
fee-for-service care
advance beneficiary notice (ABN)
allowed amount
assignment of benefits
expensive premiums, but more freedom to pick providers and st…
required by medicare when a service is provided to a benefici…
the maximum amount an insurer will pay for any given service
the authorization, by signature of the patient, for payment t…
fee-for-service care
expensive premiums, but more freedom to pick providers and st…
advance beneficiary notice (ABN)
required by medicare when a service is provided to a benefici…
36 terms
Medical Insurance, Billing and Coding
Medicare
F
56
Medicaid
Which of the following insurance claims is the provider's off…
Category II CPT codes consist of 4 digits followed by which a…
What procedure code modifier is used for preoperative managem…
Which health plan should always be treated as the payer of la…
Medicare
Which of the following insurance claims is the provider's off…
F
Category II CPT codes consist of 4 digits followed by which a…
76 terms
Medical Insurance Billing & Coding
abnormal condition that follows and is…
When the patient... (A) has to have a seq…
status are important why?
What is a prosthetic or mechanical dev…
sequelae
status codes
because they may affect the course of treatment and outcome
status code
abnormal condition that follows and is…
sequelae
When the patient... (A) has to have a seq…
status codes
26 terms
Medical insurance/ medical insurance coding
Adjustment
Assignment of benefits
Beneficiary
Coordination of benefits (COB)
Increase or decrease to patient accounts not due to changes i…
Signing over of benefits by the beneficiary to another party
Person under a policy eligible to receive benefits
The provision of a insurance contract that limits benefits to…
Adjustment
Increase or decrease to patient accounts not due to changes i…
Assignment of benefits
Signing over of benefits by the beneficiary to another party
13 terms
Medical Coding & Insurance
Assignment Of Benefits
Carriers
Coinsurance
Commercial Health Insurance (CHI)
Request made by a patient to allow the insurance carrier to p…
Parties responsible for issuing insurance policies.
Percentage of the allowed amount that is the patients respons…
Any type of health insurance not paid for by a government age…
Assignment Of Benefits
Request made by a patient to allow the insurance carrier to p…
Carriers
Parties responsible for issuing insurance policies.
39 terms
Medical coding and insurance
DRG diagnosis related group
Resource based relative value scale RB…
Major medial (catastrophic insurance
HMO
Determines payment for a hospital claim under Medicare Part A…
Used by Medicare to determine the fee schedule for Medicare P…
Assists in paying for unexpected medical expenses (hospitaliz…
Staff model: Salaried MDs work only for plan. Network Model:…
DRG diagnosis related group
Determines payment for a hospital claim under Medicare Part A…
Resource based relative value scale RB…
Used by Medicare to determine the fee schedule for Medicare P…
23 terms
Medical Insurance Coding Terms
Encounter
Diagnosis
Acute
Chronic
Every meeting between a patient and a healthcare provider. Th…
(Dx) determination of the nature of a disease based on signs,…
Ocurring now; of short term duration
Occuring over the long term or recurring frequently
Encounter
Every meeting between a patient and a healthcare provider. Th…
Diagnosis
(Dx) determination of the nature of a disease based on signs,…
Medical insurance/coding
Adjustments
Assignment of benefits
Beneficiary
Coordination of benefits (COB)
Increase or decreases to patient accounts due to charges incu…
Signing over of benefits by beneficiary to another party
Person under a policy eligible to receive benefits
Provision of an insurance contract that limits benefits to 10…
Adjustments
Increase or decreases to patient accounts due to charges incu…
Assignment of benefits
Signing over of benefits by beneficiary to another party
medical insurance coding
CPT
Category 3 codes
Modifiers
E/m codes
Level 1 HCPCS codes
Emerging technology codes
Two digit numeric codes
Services most frequently provided by physicians
CPT
Level 1 HCPCS codes
Category 3 codes
Emerging technology codes
Medical insurance/Coding
Adjustment
Assignment of benefits
Beneficiary
Coordination of benefits (COB)
increases or decreases to patient accounts not due to charges…
signing over of benefits by the beneficiary to another party
person under a policy eligible to receive benefits
the provision of an insurance contract that limits benefits t…
Adjustment
increases or decreases to patient accounts not due to charges…
Assignment of benefits
signing over of benefits by the beneficiary to another party
17 terms
Medical Insurance Coding
bundled codes
claim register
CMS-1500 (08-05)
Current Procedural Terminology (CPT)
A grouping of several services that are directly related to a…
register of claims submitted to each insurance carrier (Page…
Formerly known as the HCFA 1500 form the office health insura…
System was developed by the the American Medical Association…
bundled codes
A grouping of several services that are directly related to a…
claim register
register of claims submitted to each insurance carrier (Page…
11 terms
Medical Insurance Coding
Bundled codes
Claim register
CMS-1500- (08-05)
Down-coding
A grouping of several services that are directly related to a…
Diary or register of claims submitted to each insurance carri…
Formerly known as the HCFA 1500 form that is the office healt…
Insurance carrier's down-code if documentation or codes are a…
Bundled codes
A grouping of several services that are directly related to a…
Claim register
Diary or register of claims submitted to each insurance carri…
13 terms
Medical insurance coding
Down coding
Cms-1500(08-05)
Bundled Codes
Cpt- current prodedural terminology
insurance carriers down-code if documentation or codes are am…
formerly known as the HCFA 1500 form that is the office healt…
a group of several services that are directly related to a sp…
Standard codes for procedures and services. Used by most ambu…
Down coding
insurance carriers down-code if documentation or codes are am…
Cms-1500(08-05)
formerly known as the HCFA 1500 form that is the office healt…
11 terms
cma medical insurance coding
ICD-9-CM
ICD
CPT
EOB
INTERNATIONAL CLASSIFICATION OF DISEASES, 9TH REVISION, CLINI…
CLASSIFY ALL KNOWN DISEASES
CURRENT PROCEDURAL TERMINOLOGY
STATEMENT SUMMARIZING HOW THE INSURANCE CARRIER DETERMINED TH…
ICD-9-CM
INTERNATIONAL CLASSIFICATION OF DISEASES, 9TH REVISION, CLINI…
ICD
CLASSIFY ALL KNOWN DISEASES
28 terms
Medical insurance/coding
Adjustment
Assignment of benefits
Beneficiary
Coordination of benefits
Increases or decreases to patient accounts due to charges or…
Signing over of benefits by beneficiary to another party
Person under a policy eligible to receive benefits
The provision of an insurance contract that limits benefits t…
Adjustment
Increases or decreases to patient accounts due to charges or…
Assignment of benefits
Signing over of benefits by beneficiary to another party
Medical Insurance Billing and Coding
Procedure Code
Level 1 - Current Procedural Terminology
Code Modifiers
Multiple Modifiers (-99)
represent evaluation and management services and diagnostic a…
CPT- used in most states by providers and physicians services…
two or five digit code to give a more accurate description of…
either you can use multiple modifiers either with 2 digit (ex…
Procedure Code
represent evaluation and management services and diagnostic a…
Level 1 - Current Procedural Terminology
CPT- used in most states by providers and physicians services…
Medical Insurance Billing and Coding
Medical Insurance Billing and Coding
ICD10 Coding
CPT Coding 2015
Health Insurance Today
International Classification of Disease, 9TH Revison, Clinica…
...
...
...
Medical Insurance Billing and Coding
International Classification of Disease, 9TH Revison, Clinica…
ICD10 Coding
...
26 terms
Medical Ethics and Insurance Coding
Co-payment
Co-insurance
Deductible
RBRVS
A fixed amount of money that the patient must pay for any hea…
A percentage of the allowed charge for health services, which…
An amount of money that an insured person must pay annually b…
Resource-Based relative value scale; A system to establish th…
Co-payment
A fixed amount of money that the patient must pay for any hea…
Co-insurance
A percentage of the allowed charge for health services, which…
152 terms
Medical Coding and Insurance Final
Higher copays may be charged for patie…
Determine which of the following types…
Identify the type of HMO cost-containm…
In what format are healthcare claims s…
The office of a specialist
No covered services
Controlling drug cost
Electronic and hard copy
Higher copays may be charged for patie…
The office of a specialist
Determine which of the following types…
No covered services
35 terms
Medical Insurance and Coding
What is the largest section in the cpt…
A good coder must be fluent in what tw…
A good coder codes from the alpha.
The tabular is organized A-Z.
Surgery
Anatomy and Physiology and Terminology
False
False
What is the largest section in the cpt…
Surgery
A good coder must be fluent in what tw…
Anatomy and Physiology and Terminology
Medical Insurance Coding
HCPCS stands for:... a. Health Common Pro…
CPT stands for:... a. Comprehensive Patie…
ICD stands for:... a. Incidental Codes of…
An individual who receives Medicare is…
b. Healthcare Common Procedure Coding System
b. Current Procedural Terminology
d. International Classification of Diseases
a. Beneficiary
HCPCS stands for:... a. Health Common Pro…
b. Healthcare Common Procedure Coding System
CPT stands for:... a. Comprehensive Patie…
b. Current Procedural Terminology
Medical Billing, Coding, and Insurance-Chapter 1
Cash Flow
Accounts Receivable (AR)
Accounts Payable (AP)
Revenue Cycle Management (RCM)
movement of monies into or out of a business.
monies owed to a medical practice.
a practice's operating expenses.
process of making sure sufficient monies flow into the practi…
Cash Flow
movement of monies into or out of a business.
Accounts Receivable (AR)
monies owed to a medical practice.
17 terms
Medical Insurance Coding
bundle codes
claim register
CMS-1500 (08-05)
Current procedural Terminology
a grouping of several services that are directly related to a…
diary or register of claims submitted to each insurance carrier
office health care insurance claim form for Medicare and Medi…
Used by most ambulatory care settings in encoding the claim f…
bundle codes
a grouping of several services that are directly related to a…
claim register
diary or register of claims submitted to each insurance carrier
56 terms
Medical Prefixes - Insurance and Coding
a- an- ana-
ab-
ante-
anti-
no, not, without
away from
before
against
a- an- ana-
no, not, without
ab-
away from
54 terms
Medical Insurance Terminology Coding 1
Breach of Confidentiality
CMS-1500
Chart
Claim Form
Unauthorized release of confidential patient information to a…
The standardized claim form to submit charges to an insurance…
The patient's medical record documenting patient history, med…
A form used to submit information to an insurance company for…
Breach of Confidentiality
Unauthorized release of confidential patient information to a…
CMS-1500
The standardized claim form to submit charges to an insurance…
31 terms
Medical Billing and coding - insurance terms
Assignments of benefits
Accept assignment
New patient
Established patient
Reimbursement is directly sent from the payer to the provider
The provider agrees to accept what the insurance company appr…
Us one who has not received professional service from the phy…
One who received professional service from the physician or a…
Assignments of benefits
Reimbursement is directly sent from the payer to the provider
Accept assignment
The provider agrees to accept what the insurance company appr…
56 terms
Medical Billing, Coding, and Insurance-Chapter 1
Cash Flow
Accounts Receivable (AR)
Accounts Payable (AP)
Revenue Cycle Management (RCM)
movement of monies into or out of a business.
monies owed to a medical practice.
a practice's operating expenses.
process of making sure sufficient monies flow into the practi…
Cash Flow
movement of monies into or out of a business.
Accounts Receivable (AR)
monies owed to a medical practice.
77 terms
Medical Office Insurance: Diagnostic Coding
Proper coding can mean financial succe…
All diagnoses that affect the current…
It is possible for the primary diagnos…
When the physician makes hospital visi…
True
True
True
True
Proper coding can mean financial succe…
True
All diagnoses that affect the current…
True
43 terms
NHA INSURANCE TERMS FOR MEDICAL BILLING & CODING
assignment of benefits
accept assignment
new patient
established patient
reimbursement is directly sent from the payer to the provider
the provider agrees to accept what the insurance company appr…
one who has not received professional services from the physi…
one who has received professional services from the physician…
assignment of benefits
reimbursement is directly sent from the payer to the provider
accept assignment
the provider agrees to accept what the insurance company appr…
56 terms
Medical Billing, Coding, and Insurance-Chapter 1
Cash Flow
Accounts Receivable (AR)
Accounts Payable (AP)
Revenue Cycle Management (RCM)
movement of monies into or out of a business.
monies owed to a medical practice.
a practice's operating expenses.
process of making sure sufficient monies flow into the practi…
Cash Flow
movement of monies into or out of a business.
Accounts Receivable (AR)
monies owed to a medical practice.
100 terms
Medical Billing, Coding, & Insurance Key Terms
Abuse
Add-on codes
Adjustment
Admitting Clerk
Improper billing practices that result in financial benefit t…
CPT codes with a + symbol in front, used to specify procedure…
A positive or negative change to a patient's account balance.…
Clerk who enters patient's demographic information into a com…
Abuse
Improper billing practices that result in financial benefit t…
Add-on codes
CPT codes with a + symbol in front, used to specify procedure…
29 terms
Medical Office Insurance: Procedural Coding
Some managed care plans develop "inter…
The HCPCS consists of two levels of co…
Some private insurance companies have…
A medical practice can have more than…
True
True
True
True
Some managed care plans develop "inter…
True
The HCPCS consists of two levels of co…
True
56 terms
Medical Billing, Coding, and Insurance-Chapter 1
Cash Flow
Accounts Receivable (AR)
Accounts Payable (AP)
Revenue Cycle Management (RCM)
movement of monies into or out of a business.
monies owed to a medical practice.
a practice's operating expenses.
process of making sure sufficient monies flow into the practi…
Cash Flow
movement of monies into or out of a business.
Accounts Receivable (AR)
monies owed to a medical practice.
Chapter 18 Medical Insurance Coding:
Bundled Code:
Claim Register:
CMS-1500(08-05) :
Current Procedural Terminology(CPT):
a grouping of several several services that are directly rela…
diary or register of claims submitted to each insurance carri…
formally known as the HCFA 1500 form that is the office healt…
standard codes for procedures and service.
Bundled Code:
a grouping of several several services that are directly rela…
Claim Register:
diary or register of claims submitted to each insurance carri…
17 terms
Medical insurance coding chapter 18
Bundled codes
Claim register
Cms-1500
Current procedural terminology
one code that represents a package of services.
record of claims sent to insurance carrier.
Form used to submit Medicare claims; previously called the HC…
CPT, A reference procedural code book using a five-digit nume…
Bundled codes
one code that represents a package of services.
Claim register
record of claims sent to insurance carrier.
18 terms
Medical Insurance and Coding Chapter 1
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
160 terms
Medical Insurance & Coding Abbreviation List
dx
CLIA
HIPAA
AHA
diagnosis
Clinical Laboratory Improvement Amendment
Healthcare Insurance Portability and Accountability Act
American Hospital Association
dx
diagnosis
CLIA
Clinical Laboratory Improvement Amendment
30 terms
Medical Insurance and Coding Chapter 2
ARRA
CERT
CLIA
CMP
American Recovery and reinvestment agency
Comprehensive Error rating testing
clinical laboratory improvement amendments
Competitive medical plan
ARRA
American Recovery and reinvestment agency
CERT
Comprehensive Error rating testing
Chapter 18 (Medical Insurance Coding)
Bundled Codes
Claim Register
CMS-1500 (08-05)
Current Procedural Terminology (CPT)
...
...
...
...
Bundled Codes
...
Claim Register
...
17 terms
Ch. 18 Medical Insurance Coding
bundled codes
claim register
CMS-1500 (08-05)
Current Procedural Terminology (CPT)
a grouping of several services that are directly related to a…
diary or register of claims submitted to each insurance carri…
formerly known as the HCFA 1500 form that is the office healt…
standard codes for procedures and services, used by most ambu…
bundled codes
a grouping of several services that are directly related to a…
claim register
diary or register of claims submitted to each insurance carri…
Medical Insurance (Coding/Claims Information)
CMS
comorbidity
concurrent care
CPT (Current Procedural Terminology)
Centers 4 Medicare & Medicaid Services
condition that exists along with 4 which patient is receiving…
similar svcs provided 2 same patient on same day by different…
codes for procedural & svcs performed by doctors
CMS
Centers 4 Medicare & Medicaid Services
comorbidity
condition that exists along with 4 which patient is receiving…
17 terms
Medical insurance coding chapter 18
Bundled codes
Claim register
Cms-1500
Current procedural terminology
one code that represents a package of services
record of claims sent to insurance carrier
Form used to submit Medicare claims; previously called the HC…
CPT, A reference procedural code book using a five-digit nume…
Bundled codes
one code that represents a package of services
Claim register
record of claims sent to insurance carrier
Delmar 18 Medical Insurance Coding
EOB Explanation Of Benefits
POS Point Of Service plan
Preauthorization
Bundled codes
Insurance report that is sent with claim payments explaining…
A plan that allows direct communication between a medical off…
Obtaining an insurance carriers consent to proceed with patie…
A grouping of several services that are directly related to a…
EOB Explanation Of Benefits
Insurance report that is sent with claim payments explaining…
POS Point Of Service plan
A plan that allows direct communication between a medical off…
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