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Study sets matching "insurance medical graw hill coding billing"

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Study sets matching "insurance medical graw hill coding billing"

5 terms
medical insurance billing and coding
english
billing codes
cpt codes
medical insurance
...
icd 10
cpt 9
health insurance today
english
...
billing codes
icd 10
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
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…
5 terms
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
...
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.
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…
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.
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.
39 terms
Medical Billing, Coding, and Insurance Chapter 2
A medical record must document what fo…
Explain the term medical professional…
List 8 advantages of EHRs over paper r…
List the four types of information in…
A patient's health history, examinations, tests, and results…
Healthcare providers are legally responsible for providing a…
1. Immediate access to health information.... 2. Computerized ph…
1. The chief complaint.... 2. The history and physical examinati…
A medical record must document what fo…
A patient's health history, examinations, tests, and results…
Explain the term medical professional…
Healthcare providers are legally responsible for providing a…
60 terms
Medical Billing, Coding, and Insurance-Chapter 7
HIPAA X12 837 Health Care Claim:Profes…
CMS-1500
National Uniform Claim Committee
CMS-1500 (08/05)
is a form used to send a claim for physician services to prim…
paper claim for physician services.
organization responsible for claim content.
current paper claim approved by the NUCC.
HIPAA X12 837 Health Care Claim:Profes…
is a form used to send a claim for physician services to prim…
CMS-1500
paper claim for physician services.
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.
15 terms
Medical Billing, Coding, and Insurance Chapter 3
What is the difference between a new p…
What is the difference between a parti…
What information does a patient inform…
What is an assignment of benefits?
A new patient is someone who has not received any services fr…
A participating provider is a provider who agrees to provide…
1. First name, middle initial, and last name... 2. Gender... 3. Rac…
Assignment of benefits is an authorization allowing benefits…
What is the difference between a new p…
A new patient is someone who has not received any services fr…
What is the difference between a parti…
A participating provider is a provider who agrees to provide…
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.
39 terms
Medical Billing, Coding, and Insurance Chapter 2
A medical record must document what fo…
Explain the term medical professional…
List 8 advantages of EHRs over paper r…
List the four types of information in…
A patient's health history, examinations, tests, and results…
Healthcare providers are legally responsible for providing a…
1. Immediate access to health information.... 2. Computerized ph…
1. The chief complaint.... 2. The history and physical examinati…
A medical record must document what fo…
A patient's health history, examinations, tests, and results…
Explain the term medical professional…
Healthcare providers are legally responsible for providing a…
39 terms
Medical Billing, Coding, and Insurance Chapter 2
A medical record must document what fo…
Explain the term medical professional…
List 8 advantages of EHRs over paper r…
List the four types of information in…
A patient's health history, examinations, tests, and results…
Healthcare providers are legally responsible for providing a…
1. Immediate access to health information.... 2. Computerized ph…
1. The chief complaint.... 2. The history and physical examinati…
A medical record must document what fo…
A patient's health history, examinations, tests, and results…
Explain the term medical professional…
Healthcare providers are legally responsible for providing a…
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.
60 terms
Medical Billing, Coding, and Insurance-Chapter 7
HIPAA X12 837 Health Care Claim:Profes…
CMS-1500
National Uniform Claim Committee
CMS-1500 (08/05)
is a form used to send a claim for physician services to prim…
paper claim for physician services.
organization responsible for claim content.
current paper claim approved by the NUCC.
HIPAA X12 837 Health Care Claim:Profes…
is a form used to send a claim for physician services to prim…
CMS-1500
paper claim for physician services.
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…
59 terms
Chpt: 6 Medical Insurance, Billing and Coding
Allowed charge
Assignment of Benefits
Beneficiary
Birthday Rule
The maximum dollar amount an insurance carrier will cover for…
The patient authorizes the insurance carrier to pay the physi…
The beneficiaries are the subscriber and eligible person name…
Determines which insurance company is billed 1st (primary). T…
Allowed charge
The maximum dollar amount an insurance carrier will cover for…
Assignment of Benefits
The patient authorizes the insurance carrier to pay the physi…
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.
60 terms
Medical Billing, Coding, and Insurance-Chapter 7
HIPAA X12 837 Health Care Claim:Profes…
CMS-1500
National Uniform Claim Committee
CMS-1500 (08/05)
is a form used to send a claim for physician services to prim…
paper claim for physician services.
organization responsible for claim content.
current paper claim approved by the NUCC.
HIPAA X12 837 Health Care Claim:Profes…
is a form used to send a claim for physician services to prim…
CMS-1500
paper claim for physician services.
39 terms
Medical Billing, Coding, and Insurance Chapter 2
A medical record must document what fo…
Explain the term medical professional…
List 8 advantages of EHRs over paper r…
List the four types of information in…
A patient's health history, examinations, tests, and results…
Healthcare providers are legally responsible for providing a…
1. Immediate access to health information.... 2. Computerized ph…
1. The chief complaint.... 2. The history and physical examinati…
A medical record must document what fo…
A patient's health history, examinations, tests, and results…
Explain the term medical professional…
Healthcare providers are legally responsible for providing a…
44 terms
Medical Insurance Billing and Coding Test 1
Who is responsible for third party rei…
Two different coding systems are?
Upcoding?
What is the fastest growing patient gr…
Insurance companies
1. Inpatient ... 2. Outpatient
Charging more than treatment costs
Elderly
Who is responsible for third party rei…
Insurance companies
Two different coding systems are?
1. Inpatient ... 2. Outpatient
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…
Medical Insurance Billing/Coding Chapter 1&18
In a medical practice, front office du…
Generally, a high school diploma is no…
Working in a physician's office as an…
The medical profession has long subscr…
F
F
F
F
In a medical practice, front office du…
F
Generally, a high school diploma is no…
F
39 terms
Medical Billing, Coding, and Insurance Chapter 2
A medical record must document what fo…
Explain the term medical professional…
List 8 advantages of EHRs over paper r…
List the four types of information in…
A patient's health history, examinations, tests, and results…
Healthcare providers are legally responsible for providing a…
1. Immediate access to health information.... 2. Computerized ph…
1. The chief complaint.... 2. The history and physical examinati…
A medical record must document what fo…
A patient's health history, examinations, tests, and results…
Explain the term medical professional…
Healthcare providers are legally responsible for providing a…
75 terms
Medical Billing & Coding Heald College: Chapter 3 | Basics of Health Insurance
Health Insurance
Implied Contract
Expressed Contract
Guarantor
A contract between the policy holder or member and the insura…
A contract between physician and patient not manifested by di…
A verbal or written agreement.
An individual who promises to pay the medical bill by signing…
Health Insurance
A contract between the policy holder or member and the insura…
Implied Contract
A contract between physician and patient not manifested by di…
39 terms
NCCT Insurance/coding Specialist- Medical Insurance & billing Procedures
1. In order to work competently as a m…
2. Information that must be included i…
3. Medical ethics will typically addre…
Everything that a medical claims speci…
b. to know procedural and diagnostic coding.
d. the state
d. Conduct
Confidential
1. In order to work competently as a m…
b. to know procedural and diagnostic coding.
2. Information that must be included i…
d. the state
172 terms
Medical Coding and Insurance Billing Ch1-7 (2)
As blood enters the heart form the hea…
Break down the following words: Root w…
Break down the following words: Suffix…
Break down the following words: Word m…
Superior Vena Cava, (vena) cava; atrium, entricle; pulmonary;…
Isch; Lack of
Emia; Blood condition
lack of blood
As blood enters the heart form the hea…
Superior Vena Cava, (vena) cava; atrium, entricle; pulmonary;…
Break down the following words: Root w…
Isch; Lack of
75 terms
Medical Billing & Coding Heald College: Chapter 3 | Basics of Health Insurance
Health Insurance
Implied Contract
Expressed Contract
Guarantor
A contract between the policy holder or member and the insura…
A contract between physician and patient not manifested by di…
A verbal or written agreement.
An individual who promises to pay the medical bill by signing…
Health Insurance
A contract between the policy holder or member and the insura…
Implied Contract
A contract between physician and patient not manifested by di…
27 terms
Medical Billing & Coding Heald College: Chapter 1 | Role of Insurance Billing Specialist
Cash Flow
Revenue
Cycle
Charge Entry
The amount of actual money available in a medical practice.
Income of a clinic or medical practice.
The period of time and steps dedicated to billing patients an…
The process of posting charges into the system for billing an…
Cash Flow
The amount of actual money available in a medical practice.
Revenue
Income of a clinic or medical practice.
Medical Billing & Coding Heald College: Chapter 3 | Basics of Health Insurance
Health Insurance
Implied Contract
Expressed Contract
Guarantor
A contract between the policy holder or member and the insura…
A contract between physician and patient not manifested by di…
A verbal or written agreement.
An individual who promises to pay the medical bill by signing…
Health Insurance
A contract between the policy holder or member and the insura…
Implied Contract
A contract between physician and patient not manifested by di…
172 terms
Medical Coding and Insurance Billing Ch1-7 (2)
As blood enters the heart form the hea…
Break down the following words: Root w…
Break down the following words: Suffix…
Break down the following words: Word m…
Superior Vena Cava, (vena) cava; atrium, entricle; pulmonary;…
Isch; Lack of
Emia; Blood condition
lack of blood
As blood enters the heart form the hea…
Superior Vena Cava, (vena) cava; atrium, entricle; pulmonary;…
Break down the following words: Root w…
Isch; Lack of
156 terms
Medical Coding and Insurance Billing Ch1-7 Flashcard
Define the root: Athero/o
Define the root: Granul/o
Define the root: Morph/o
Define the root: Thym/o
Vessel
Grain
Change Shape
Thymus Gland
Define the root: Athero/o
Vessel
Define the root: Granul/o
Grain
75 terms
Medical Billing & Coding DeskTop Learning: Test | Basics of Health Insurance
Health Insurance
Implied Contract
Expressed Contract
Guarantor
A contract between the policy holder or member and the insura…
A contract between physician and patient not manifested by di…
A verbal or written agreement.
An individual who promises to pay the medical bill by signing…
Health Insurance
A contract between the policy holder or member and the insura…
Implied Contract
A contract between physician and patient not manifested by di…
100 terms
Comprehensive Health Insurance: HCPCS and Coding, Auditing, Physician Medical Billing
Once a Medicare beneficiary signs the…
What modifier identifies an ABN on file?
If a chart note documents that the pat…
What is HPI?
Advance Beneficiary Notice (ABN)
HCPCS GA modifier
past history: the review of the patient's experiences with il…
History of Present illness: chronological description of the…
Once a Medicare beneficiary signs the…
Advance Beneficiary Notice (ABN)
What modifier identifies an ABN on file?
HCPCS GA modifier
27 terms
Medical Billing & Coding Heald College: Chapter 1 | Role of Insurance Billing Specialist
Cash Flow
Revenue
Cycle
Charge Entry
The amount of actual money available in a medical practice.
Income of a clinic or medical practice.
The period of time and steps dedicated to billing patients an…
The process of posting charges into the system for billing an…
Cash Flow
The amount of actual money available in a medical practice.
Revenue
Income of a clinic or medical practice.
8 terms
Medical Insurance Billing and Codes Chapter 1 study guide
What is Health Insurance?
What is a Health Care Provider?
What is a Health Care Specialists?
What is a Claims Examiner?
Contract between a policyholder and third party or government
Physician or other health care practioner
Review health related claims to determine necessity
Reviews health related claims to determine if charges are rea…
What is Health Insurance?
Contract between a policyholder and third party or government
What is a Health Care Provider?
Physician or other health care practioner
Comprehensive Health Insurance:Billing, Coding & Reimbursement Chapter 11-Physician Medical Billing: Study Guide
The majority of income in a physician'…
A patient information form typically i…
The person who is ultimately responsib…
If an insured patient signs an Assignm…
Payments from insurance companies.
Demographic information, employment information, insurance in…
Guarantor
Physician
The majority of income in a physician'…
Payments from insurance companies.
A patient information form typically i…
Demographic information, employment information, insurance in…
27 terms
Medical Billing & Coding Heald College: Chapter 1 | Role of Insurance Billing Specialist
Cash Flow
Revenue
Cycle
Charge Entry
The amount of actual money available in a medical practice.
Income of a clinic or medical practice.
The period of time and steps dedicated to billing patients an…
The process of posting charges into the system for billing an…
Cash Flow
The amount of actual money available in a medical practice.
Revenue
Income of a clinic or medical practice.
17 terms
Insurance Billing and Coding Chapter 2: Tools of the Trade: A Career as a Health (Medical) Insurance Professional
application
autonomy
certification
CMS-1500 claim form
...
...
...
...
application
...
autonomy
...
109 terms
My Medical Coding, Billing, Insurance TEST 1 STUDY Ch. 1-2-3
A system used to gather a patient's cl…
Monies used by the physician practice…
Which of the following data is stored…
Participants in the medical insurance…
Electronic health record
Accounts Payable
Transaction data... Provider data... Health plan data... All of these
Provider... Patient... Health plan... All of these
A system used to gather a patient's cl…
Electronic health record
Monies used by the physician practice…
Accounts Payable
11 terms
Ost-148 Medical Billing, Coding, and Insurance Mid-Term Review, Chapter 1
Centers for Medicare and Medicaid
Department of Health and Human Services
Coding
International Classification of Diseas…
Administrative agency within the federal Department of Health…
Announces the implementation of new regulations about governm…
The process of assigning ICD-10-CM, ICD-10-PCS, CPT and HCPCS…
Coding system used to report diseases, injuries, and other re…
Centers for Medicare and Medicaid
Administrative agency within the federal Department of Health…
Department of Health and Human Services
Announces the implementation of new regulations about governm…
9 terms
Ost-148 Medical Billing, Coding, and Insurance Mid-Term Review, Chapter 3
Capitation
Case Management
Enrollees
Fee-for-Service
Provider accepts pre-established payments for providing healt…
Development of patient care plans to coordinate and provide c…
Also called covered lives: employees and dependents who join…
Reimbursement methodology that increases payment if the healt…
Capitation
Provider accepts pre-established payments for providing healt…
Case Management
Development of patient care plans to coordinate and provide c…
8 terms
Ost-148 Medical Billing, Coding, and Insurance Mid-Term Review, Chapter 2
CMS-1500
Co-payment
Deductible
Diagnosis Related Group (DRG)
Form used to submit Medicare claims; previously called HCFA-1…
Provision in an health insurance policy that requires the pol…
Amount for which the patient is financially responsible befor…
Prospective payment system that reimburses hospitals for inpa…
CMS-1500
Form used to submit Medicare claims; previously called HCFA-1…
Co-payment
Provision in an health insurance policy that requires the pol…
Comprehensive Health Insurance:Billing, Coding & Reimbursement Chapter 3-Understanding Managed Care:Medical Contracts and Ethics: StudyGuide
Provisions included in a managed care…
Contracts between the physician and ma…
A managed care contract is considered…
MCOs develop a network by contracting…
What is expected of the provider, time limits for submitting…
Physician or upper management
provider and insurer
Physicians, facilities, and pharmacies
Provisions included in a managed care…
What is expected of the provider, time limits for submitting…
Contracts between the physician and ma…
Physician or upper management
25 terms
Medical Assistant Practice Exam - Content Area II: Admin Knowledge Section 5 - Billing, Coding and Insurance
ICD-9 coding books:... a.... ... are organized…
The CPT Coding Book:
The following symbol (*):... a.... ... is used…
The modifier that notes, "Bilateral Pr…
a - ICD-9 coding manuals are organized into three separate se…
Volume II of the ICD-9 coding book is the three part alphabet…
c - Symbols used in the CPT coding manual are used to add add…
b - Modifiers are used with CPT codes to add additional infor…
ICD-9 coding books:... a.... ... are organized…
a - ICD-9 coding manuals are organized into three separate se…
The CPT Coding Book:
Volume II of the ICD-9 coding book is the three part alphabet…
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