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Study sets matching "medical billing insurance coding 3"

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Study sets matching "medical billing insurance coding 3"

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
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…
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
...
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…
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.
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…
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…
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…
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…
74 terms
Medical Billing Insurance Ch. 3
cash flow
revenue cycle management (RCM)
Pre-Claim section of medical billing c…
New Patient (NP)
movement of monies into or out of a business
the actions that ensure the provider receives the maximum app…
processing encounters for billing purposes
patient who has not seen a provider withing the past three ye…
cash flow
movement of monies into or out of a business
revenue cycle management (RCM)
the actions that ensure the provider receives the maximum app…
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…
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.
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…
25 terms
Medical Billing and Coding #3
the amount is ___, how would you like…
Prompt payment from the credit card co…
Emancipated Minor
Single entry account
What is the diplomatic way to ask a patient for payment?
What does a credit card payment to the office mean?
Someone who is their own legal guardian and is no longer unde…
Used when a patient is visiting the office only one time, and…
the amount is ___, how would you like…
What is the diplomatic way to ask a patient for payment?
Prompt payment from the credit card co…
What does a credit card payment to the office mean?
20 terms
Intro to insurance coding & Billing insurance terms #3
Emergency
Third Party Payer
critical care
Observation status
Sudden or unexpected medical condition (e.g chest pain, short…
an organization that provides payment for specified coverage…
a critical illness or injury which acutely impairs one or mor…
an outpatient service that allows patients to be monitored in…
Emergency
Sudden or unexpected medical condition (e.g chest pain, short…
Third Party Payer
an organization that provides payment for specified coverage…
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
199 terms
MEDICAL BILLING/CODING ACRONYMS
Acct.
A/P
A/R
AMA
Account
ACCOUNT Payable
Account Receivable
American Medical Association
Acct.
Account
A/P
ACCOUNT Payable
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
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…
44 terms
Insurance Billing and Coding
Define Provider...
What is an EOB ?
What is an RA?
What is a Co-Pay?
A physician or other qualified healthcare worker
Explanation of Benefits; sent to the patient and explains how…
Remittance Advice; sent to the provider and explains how clai…
A flat amount paid by the patient at the time of service
Define Provider...
A physician or other qualified healthcare worker
What is an EOB ?
Explanation of Benefits; sent to the patient and explains how…
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…
30 terms
Medical Billing & Coding Module 3
Encounter
Eponyms
Parentheses
Brackets
is a face-to-face contact between a patient and a health care…
diseases or syndromes that are named for people. They are lis…
used in the index and tabular list to enclose nonessential mo…
used in the index to identify manifestation codes and in the…
Encounter
is a face-to-face contact between a patient and a health care…
Eponyms
diseases or syndromes that are named for people. They are lis…
74 terms
Medical Billing Insurance Ch. 3
cash flow
revenue cycle management (RCM)
Pre-Claim section of medical billing c…
New Patient (NP)
movement of monies into or out of a business
the actions that ensure the provider receives the maximum app…
processing encounters for billing purposes
patient who has not seen a provider withing the past three ye…
cash flow
movement of monies into or out of a business
revenue cycle management (RCM)
the actions that ensure the provider receives the maximum app…
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
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.
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
74 terms
Medical Billing Insurance Ch. 3
cash flow
revenue cycle management (RCM)
Pre-Claim section of medical billing c…
New Patient (NP)
movement of monies into or out of a business
the actions that ensure the provider receives the maximum app…
processing encounters for billing purposes
patient who has not seen a provider withing the past three ye…
cash flow
movement of monies into or out of a business
revenue cycle management (RCM)
the actions that ensure the provider receives the maximum app…
21 terms
Insurance and Coding- Chapter 1 - Insurance and Billing Procedures
In addition to medical data, the medic…
medical ethics will typically address…
how do you correct an error in a patie…
insurance policy
personal data, financial data, social data
conduct
draw a single line through it
a legally enforceable document composed by an insurance compa…
In addition to medical data, the medic…
personal data, financial data, social data
medical ethics will typically address…
conduct
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
34 terms
Medical Billing Insurance Exam 3
Medicaid is administered by?
All Americans younger than age 65 with…
SSI is a cash benefit program controll…
A state opinion that provides individu…
The Centers of Medicare and Medicaid Services (CMS)
2014
The Social Security Administration
Community First Choice Option
Medicaid is administered by?
The Centers of Medicare and Medicaid Services (CMS)
All Americans younger than age 65 with…
2014
111 terms
NHA Billing & Coding - Ch 3 - Insurance Principles
adjustment
allowed amount
benefits
Civilian Health and Medical Program of…
remaining portion after the insurance carrier has met its fin…
the maximum dollar amount the third party will reimburse a pr…
the health insurance coverage a member receives and the speci…
provides health care benefits to individuals with 100% servic…
adjustment
remaining portion after the insurance carrier has met its fin…
allowed amount
the maximum dollar amount the third party will reimburse a pr…
20 terms
Week 3, insurance coding & billing #120
Emergency
Third party payer
Critical care
Observation status
Sudden or unexpected medical condition (e.g. Chest pain , sho…
An organization that provides payment for specified coverage…
A critical illness or injury which acutely impairs one to be…
An outpatient service that allows patients to be monitored in…
Emergency
Sudden or unexpected medical condition (e.g. Chest pain , sho…
Third party payer
An organization that provides payment for specified coverage…
55 terms
Insurance Billing and Coding Ch. 1,2,3
Indemnity Plan
Third party payer
EMR
EHR
provides protection against loss
private or government organization insuring or paying for hea…
electronic medical record-practices records
electronic health records for multiple medical sites that can…
Indemnity Plan
provides protection against loss
Third party payer
private or government organization insuring or paying for hea…
86 terms
137 Billing & Insurance, Coding unit 3
What are the two main organization com…
One difference between ICD-9 and ICD-1…
ICD-10 CM must be used for diagnostic…
In diagnostic coding, the coexisting c…
Alphabetic Index and Tabular List
True
True
False
What are the two main organization com…
Alphabetic Index and Tabular List
One difference between ICD-9 and ICD-1…
True
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