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Study sets matching "mast1100 medical insurance"

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Study sets matching "mast1100 medical insurance"

85 terms
MAST 1100- Medical Insurance Management
Define benefits
Define coinsurance. Who pays coinsuran…
Define consumer-driven health plan.
Patient information forms should be __…
The amount of money a health plan pays for services covered i…
The portion of charges that an insured person must pay for he…
Type of medical insurance that combines a high-deductible hea…
Updated.
Define benefits
The amount of money a health plan pays for services covered i…
Define coinsurance. Who pays coinsuran…
The portion of charges that an insured person must pay for he…
47 terms
Medical insurance chapter 8
Administrative services only (ASO)
Blue card
BlueCross BkueShield Association (BCBS)
Carve out
Contract under which a third party administrator or insurer p…
program that provides benefits for subscribers who are away f…
National health care licensing association
Part of a standard health plan changed under an employer-spon…
Administrative services only (ASO)
Contract under which a third party administrator or insurer p…
Blue card
program that provides benefits for subscribers who are away f…
35 terms
CMAac: Chapter (18) Medical Insurance and Coding
Advance beneficiary notice
Annual premium
Bundling
Children's Health Insurance Program (C…
A notification of costs of services that are not covered by M…
The amount an individual pays to purchase health insurance ea…
A practice by insurance providers in which they pay for only…
A program within Medicaid that provides medical coverage for…
Advance beneficiary notice
A notification of costs of services that are not covered by M…
Annual premium
The amount an individual pays to purchase health insurance ea…
20 terms
Chapter 12 Workers' Compensation and Disability/ Automotive Insurance.
admission of liability
automobile insurance policy
disability compensation program
Federal Employees' Compensation Act (F…
determination that an employer is responsible for an employee…
contract between an insurance company and an individual for w…
plans that provide partial reimbursement for lost income when…
law that provides workers' compensation insurance for civilia…
admission of liability
determination that an employer is responsible for an employee…
automobile insurance policy
contract between an insurance company and an individual for w…
54 terms
MAST 1100 Chapter 10-12
Categorically Needy
Sponsor
Dual-Eligible
Medically Needy
a person who receives assistance from government programs suc…
the uniformed service member in a family qualified for TRICAR…
a Medicare-Medicaid beneficiary
Medicaid classification for people with high medical expenses…
Categorically Needy
a person who receives assistance from government programs suc…
Sponsor
the uniformed service member in a family qualified for TRICAR…
29 terms
CH10 MEDICAID
Eligibility for the Temporary Assistan…
Medicaid recipients who earn enough mo…
Medicaid is a federal and state assist…
The medical insurance specialist shoul…
D) county level
B) medically needy
A) True
A) True
Eligibility for the Temporary Assistan…
D) county level
Medicaid recipients who earn enough mo…
B) medically needy
41 terms
MAST 1100 CHAPTER 4
Acute
Alphabetic Index
Category
Chief Complaint
Short duration
Lists disease and injuries alphabetically w/ diagnosis
Three-digit code used for classifying a disease or condition
Patients description of the symptoms or reasons for seeking m…
Acute
Short duration
Alphabetic Index
Lists disease and injuries alphabetically w/ diagnosis
17 terms
MAST 1100 Ch. 13 & 14
Adjudication
Concurrent Care
Suspended
Development
the process followed by health plans to examine claims and de…
refers to medical attention when the patient receives extensi…
claim status when the payer is developing the claim
process of gathering information to adjudicate a claim
Adjudication
the process followed by health plans to examine claims and de…
Concurrent Care
refers to medical attention when the patient receives extensi…
13 terms
HIMT 1100 - Chapter 2
1920s
1930s
BCBS
1965
During this time, hospitals were places for terminally ill an…
Blue Cross was developed during this decade.
the model for prepaid health insurance that charged all insur…
Medicare and Medicaid were signed into law.
1920s
During this time, hospitals were places for terminally ill an…
1930s
Blue Cross was developed during this decade.
63 terms
MAST 1100 Test 2
Provider Withhold
Walkout Receipt
Required Data Element
Situational Data Element
amount withheld from a provider's payment by an MCO under con…
report given to the patient that lists the diagnoses, service…
Information that must be supplied on an electronic form
information that must be supplied on a claim when certain dat…
Provider Withhold
amount withheld from a provider's payment by an MCO under con…
Walkout Receipt
report given to the patient that lists the diagnoses, service…
25 terms
Lesson 3 Elements: Dean Vaughn Medical Terminology
cost
gram
acro
rhexis
rib
record
extremities
break, burst
cost
rib
gram
record
9 terms
Hlth 1100 Ch. 1
Which of the following were cited by c…
A disease that begins slowly, progress…
Which type of costs are related to hig…
Determinants of health are critical in…
Stress, anxiety, and sleep difficulties
Chronic Disease
Indirect medical costs
Make the difference between illness and health
Which of the following were cited by c…
Stress, anxiety, and sleep difficulties
A disease that begins slowly, progress…
Chronic Disease
28 terms
Chapter 14 Patient Billing and Collections
bad debt
bankruptcy
collection agency
collection ratio
Account deemed uncollectible.
Declaration that a person is unable to pay his or her debt.
outside firm hired to collect overdue accounts.
Average number of days it takes a practice to convert its acc…
bad debt
Account deemed uncollectible.
bankruptcy
Declaration that a person is unable to pay his or her debt.
15 terms
Chapter 10 Medicaid
categorically needy
children's health insurance program (C…
crossover claim
dual-eligible
person who receives assistance from government programs.
program that offers health insurance coverage for uninsured c…
claim for a Medicare or Medicaid beneficiary.
Medicare-Medicaid beneficiary.
categorically needy
person who receives assistance from government programs.
children's health insurance program (C…
program that offers health insurance coverage for uninsured c…
25 terms
MA 1100 Chpt 3 Dean Vaughn
cost
gram
acro
rhexis
rib
record
extremeties
break burst
cost
rib
gram
record
31 terms
Chapter 13 Payments (RAs), Appeals and Secondary Claims
aging
appeal
appellant
autoposting
classification of accounts receivable by length of time
request for reconsideration of a claim adjudication
one who appeals a claim decision
software feature enabling automatic entry of payments on a re…
aging
classification of accounts receivable by length of time
appeal
request for reconsideration of a claim adjudication
51 terms
MAST 1100 Test 3 Ch. 8&9
Group Health Plan (GHP)
Rider
Carve Out
Open Enrollment Period
Plan of an employer or employee organization to provide healt…
Document that modifies an insurance contract
Part of a standard health plan changed under an employee-spon…
Time when a policyholder selects from offered benefits
Group Health Plan (GHP)
Plan of an employer or employee organization to provide healt…
Rider
Document that modifies an insurance contract
39 terms
HIMT 1100 - Chapter 4
Veterans Affairs
Blue Button app
patient record formats
primary purpose of the health record
US government department that created the Blue Button app
application used to download parts of a medical record
paper, electronic or hybrid
support the direct care of the patient
Veterans Affairs
US government department that created the Blue Button app
Blue Button app
application used to download parts of a medical record
17 terms
Chapter 11 Tricare and Champva
catastrophic cap
catchment area
civilian health and medical program of…
civilian health and medical program of…
maximum annual amount a Tricare beneficiary must pay for dedu…
geographic area served by a hospital, clinic, or dental clinic.
program that shares healthcare costs for families of veterans…
now the Tricare program.
catastrophic cap
maximum annual amount a Tricare beneficiary must pay for dedu…
catchment area
geographic area served by a hospital, clinic, or dental clinic.
30 terms
Hlth 1100 Ch. 16
Taking responsibility for your health…
Communicating with health care provide…
The primary difference between a board…
In a clinical trial for a new pain med…
Using over-the-counter medications to treat illness such as s…
Relying on your health care provider for all information abou…
Certified physician has demonstrated competency in a given sp…
A placebo effect.
Taking responsibility for your health…
Using over-the-counter medications to treat illness such as s…
Communicating with health care provide…
Relying on your health care provider for all information abou…
19 terms
Chapter 7 Keyterms
Benefits
Birthday Rule
CMS-1500
Coordination of Benefits
Coverd services available to an individual or group by a heal…
A coordination of benefit rule that determines the order of b…
The claim form used for submitting medical services for payme…
Process of managing benefits when an individual is covered un…
Benefits
Coverd services available to an individual or group by a heal…
Birthday Rule
A coordination of benefit rule that determines the order of b…
39 terms
Chapter 9 Medicare
advance beneficiary notice of noncover…
annual wellness visit
carrier
clinical laboratory improvement amendm…
form used to inform patients that a service is not likely to…
preventive service providing a health risk assessment and per…
health plan.
laws establishing standards for laboratory testing.
advance beneficiary notice of noncover…
form used to inform patients that a service is not likely to…
annual wellness visit
preventive service providing a health risk assessment and per…
41 terms
Chapter 4 Terms Diagnostic Coding: ICD-10-CM
acute
alphabetic index
category
chief complaint (CC)
Description of an illness or condition having severe symptoms…
a part of ICD-10-CM that lists disease and injuries alphabeti…
A three-digit code used for classifying a disease or condition.
a patient's description of the symptoms or other reasons for…
acute
Description of an illness or condition having severe symptoms…
alphabetic index
a part of ICD-10-CM that lists disease and injuries alphabeti…
31 terms
Chapter 5 Procedural coding: CPT and HCPCS
add-on code
bundling
category I codes
category II codes
procedure that is performed and reported only in addition to…
using a single procedure code that covers a group of related…
procedure codes found in the main body of CPT (evaluation and…
optional CPT codes that track performance measures for a medi…
add-on code
procedure that is performed and reported only in addition to…
bundling
using a single procedure code that covers a group of related…
31 terms
Chapter 7 Healthcare Claim Preparation and Transmission
5010 version
administrative code set
billing provider
carrier block
new format for EDI transactions
under HIPAA, required codes for various data elements, such a…
the person or organization often a clearinghouse or billing s…
data entry area located in the upper right of the CMS-1500 th…
5010 version
new format for EDI transactions
administrative code set
under HIPAA, required codes for various data elements, such a…
30 terms
Chapter 9
Physicians who participate in the Medi…
The Medicare allowed charge for a proc…
The amounts paid to PAR providers in M…
An individual who is eligible for both…
excluded from coverage
$64/$16
MFS
Medi-Medi beneficiary
Physicians who participate in the Medi…
excluded from coverage
The Medicare allowed charge for a proc…
$64/$16
40 terms
HLTH 1100 chapter 16
Self-care involves all of the followin…
You should seek expert medical care if…
Conventional, scientifically based med…
Due to the differences in training, an…
ignoring body signals and "toughing it out."
All of these
allopathic.
low back pain
Self-care involves all of the followin…
ignoring body signals and "toughing it out."
You should seek expert medical care if…
All of these
69 terms
Medical czech - 13 Lekarna
lékárna
lékárník
(ne)návykový lék
batolecí věk
pharmacy
pharmacist
(non)addictive medicine
toddler age
lékárna
pharmacy
lékárník
pharmacist
42 terms
Chapter 6 Visit Charges And Compliant Billing
adjustment
advisory opinion
allowed charge
assumption coding
a change, positive or negative, to correct a patient's accoun…
opinion issued by CMS or OIG that becomes legal advice.
maximum charge that a health plan pays for a specific service…
reporting undocumented services that the coder assumes have b…
adjustment
a change, positive or negative, to correct a patient's accoun…
advisory opinion
opinion issued by CMS or OIG that becomes legal advice.
14 terms
Health 1100 Ch 1.
Chronic Disease
Genetic Diseases
Perceived Susceptibility
Living near a hiking trail to encourag…
A disease that begins slowly, progresses over a period of tim…
All the following causes of death are linked to modifiable li…
An adolescent smoker might think lung cancer happens only to…
An example of an enabling factor is
Chronic Disease
A disease that begins slowly, progresses over a period of tim…
Genetic Diseases
All the following causes of death are linked to modifiable li…
68 terms
Medical Coding Abbreviations/Definitions
CMS
AAMA
DRG
HMO
Centers for Medicare and Medicaid Services
American Association of Medical Assistants
Diagnosis-Related Group
Health Maintenance Organization
CMS
Centers for Medicare and Medicaid Services
AAMA
American Association of Medical Assistants
20 terms
Chapter 8 Keyterms
Advanced Beneficiary Notice
American National Standards Institute(…
Coordination of Benefits Agreement(COBA)
Coordination if Benefits Contractor( C…
A form created to alert a patient with Medicare when a proced…
National standard guidelines for the completion and submissio…
The system that ensures insurance payments do not exceed 100%…
The agency responsible for the processing of all supplemental…
Advanced Beneficiary Notice
A form created to alert a patient with Medicare when a proced…
American National Standards Institute(…
National standard guidelines for the completion and submissio…
33 terms
HSA 1100 Midterm
Problems with US Health Care System
Quad Function Model (+ descriptions)
Private insurance
Public insurance
- Low standardization ... - Low coordination between private and…
1) Financing - money to obtain health insurance... 2) Insurance…
provided by employers
provided through govn't programs
Problems with US Health Care System
- Low standardization ... - Low coordination between private and…
Quad Function Model (+ descriptions)
1) Financing - money to obtain health insurance... 2) Insurance…
20 terms
Chapter 17
The division of the federal government…
Which of the following is NOT true reg…
PHI stands for
The parent is not considered the child…
OCR
Few boundaries are set on the use and release of health recor…
Protected health information
When the minor consents to care and the consent of the parent…
The division of the federal government…
OCR
Which of the following is NOT true reg…
Few boundaries are set on the use and release of health recor…
157 terms
Hlth 1100 Final Review
Which of the following were cited by c…
A disease that begins slowly, progress…
Which type of costs are related to hig…
Determinants of health are critical in…
Stress, anxiety, and sleep difficulties
Chronic Disease
Indirect medical costs
Make the difference between illness and health
Which of the following were cited by c…
Stress, anxiety, and sleep difficulties
A disease that begins slowly, progress…
Chronic Disease
47 terms
HLTH 1100 Chapter 13- Health Care Delivery in the United States
Population-based public health practice
Medical practice
Long-term practice
End-of-life practice
interventions aimed at disease prevention and health promotio…
primary medical care= clinical preventative services, first-c…
restorative care= provided after surgery or other treatment…
provided shortly before death... -hospice care
Population-based public health practice
interventions aimed at disease prevention and health promotio…
Medical practice
primary medical care= clinical preventative services, first-c…
9 terms
Chapter 9 Keyterms
Beneficiary
Dual Eligibles
Fiscal Agent
Medically Needy
A patient covered under the Medicaid program
Individual who are entitled to a Medicaid benefit along with…
An association contracted to provide a system for processing,…
Persons who are eligible for Medicaid and whose income, total…
Beneficiary
A patient covered under the Medicaid program
Dual Eligibles
Individual who are entitled to a Medicaid benefit along with…
8 terms
Chapter 9 Key terms
Resident Alien
Beneficiary or Recipient
Qualified Provider
Presumptive Eligibility
One who has temporary or permanent residence in a foreign cou…
A patient covered under the Medicaid program
A provider designated by the Dept. of Human Services to deter…
A limited period of time for which a categorically needy preg…
Resident Alien
One who has temporary or permanent residence in a foreign cou…
Beneficiary or Recipient
A patient covered under the Medicaid program
32 terms
HSA 1100 Final
Characteristics of US Health Care System
What is the goal of managed care?
Where is the most health care money sp…
What setting employs the most employees?
- Large... - Uncoordinated... - Wasteful... - Private vs. Public servi…
To better combine/coordinate the 4 aspects of the Quad Functi…
Hospitals
Hospitals
Characteristics of US Health Care System
- Large... - Uncoordinated... - Wasteful... - Private vs. Public servi…
What is the goal of managed care?
To better combine/coordinate the 4 aspects of the Quad Functi…
10 terms
HLTH 1100 | HILLMAN | CHAPTER 16 QUIZ
Self-care involves all of the followin…
You should seek expert medical care if…
Conventional, scientifically based med…
Due to the differences in training, an…
Ignoring body signals and "toughing it out."
All of these
Allopathic
Low back pain
Self-care involves all of the followin…
Ignoring body signals and "toughing it out."
You should seek expert medical care if…
All of these
21 terms
1100 CH 9 (Medicare)
Medicare
Medicare beneficiary
Medicare administrative contractors (M…
Medicare Part A
Federal health insurance program for people who are sixty-fiv…
A person covered by Medicare; some qualify through Social Sec…
Insurance companies that process claims
Helps pay for inpatient hospitalization, care in a skilled nu…
Medicare
Federal health insurance program for people who are sixty-fiv…
Medicare beneficiary
A person covered by Medicare; some qualify through Social Sec…
34 terms
Insurance Review
Deductible
Property Damage Liability
Bodily Injury Liability
Comprehensive Coverage
The amount you pay for a loss before the insurance company pa…
coverage covers another person's CAR when you are at fault.
coverage pays for injuries to OTHER parties when the accident…
pays for damages to your car for damages to your car caused b…
Deductible
The amount you pay for a loss before the insurance company pa…
Property Damage Liability
coverage covers another person's CAR when you are at fault.
67 terms
Medical czech - 13
Lekarnik
Navykovy lek
Batoleci vek
Bolest různeho původu
Pharmacist
Addictive medicine
Toddler age
A pain of various origin
Lekarnik
Pharmacist
Navykovy lek
Addictive medicine
57 terms
MAST 1110 Administrative Practice Management
What is accounting?
Cash basis of accounting?
Truth in Lending
Collection procedures.
Term for systematic recording and reporting of financial tran…
Generally used by medical offices, enters income when payment…
The legal requirement to discursive the terms of. A loan to b…
...
What is accounting?
Term for systematic recording and reporting of financial tran…
Cash basis of accounting?
Generally used by medical offices, enters income when payment…
246 terms
MAST 1060 Final
HMO
Homepathy
IPA
Integrative Medicine
health maintenance organizations; designed to provide a full…
a healing modality that uses diluted doses of certain substan…
independent provider association; independent network of phys…
bringing together of two or more treatment modalities os they…
HMO
health maintenance organizations; designed to provide a full…
Homepathy
a healing modality that uses diluted doses of certain substan…
29 terms
creating the facility environment/ the medical assistant as office manager
agenda
ancillary services
authoritarian
benchmark
printed list topics to be discuessed during a meeting, giving…
professional occupational companies hire to complete a specif…
operates on the premise that most workers cannot make a contr…
making a comparison among different organizations relative to…
agenda
printed list topics to be discuessed during a meeting, giving…
ancillary services
professional occupational companies hire to complete a specif…
50 terms
Insurance and Coding - Chapter 2 - Terminology
adverse effect
hypertension
proximal and distal refer to
plantar flexion is a movement of the
an unintended reaction to a drug
the medical term for high blood pressure
proximity
foot
adverse effect
an unintended reaction to a drug
hypertension
the medical term for high blood pressure
30 terms
HLTH 1100 | HILLMAN | CHAPTER 16 TEST
Taking responsibility for your health…
Communicating with health care provide…
The primary difference between a board…
In a clinical trial for a new pain med…
Using over-the-counter medications to treat illness such as s…
Relying on your health care provider for all information abou…
A board certified physician has demonstrated competency in th…
A placebo effect
Taking responsibility for your health…
Using over-the-counter medications to treat illness such as s…
Communicating with health care provide…
Relying on your health care provider for all information abou…
216 terms
Ch. 12 - Integumentary System
squamous epithelial tissue
basal layer
keratin
melanocytes
upper layer of the epidermis; consists of flat, scaly cells t…
lowest layer of the epidermis; new cells are produced here
fibrous, water-repellant protein; can be hard or soft
special cells in the basal layer that produce and contain pig…
squamous epithelial tissue
upper layer of the epidermis; consists of flat, scaly cells t…
basal layer
lowest layer of the epidermis; new cells are produced here
22 terms
Chapter 1: Abbreviations
AED
BP
D₅₀
BiPAP
Automated External Defibrillator
Blood Pressure
50% Dextrose in water
Bilevel Positive Airway Pressure
AED
Automated External Defibrillator
BP
Blood Pressure
1 of 3