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Study sets matching "medical billing process set"

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Study sets matching "medical billing process set"

32 terms
Medical Office Billing Process
Accounting Cycle
Accounts Receivable(AR)
Adjudication
Billing Cycle
Flow of financial transactions in a business.
Monies that are flowing IN to a business.
Series of steps that determine whether a claim should be paid.
Regular schedule of sending statements to patients.
Accounting Cycle
Flow of financial transactions in a business.
Accounts Receivable(AR)
Monies that are flowing IN to a business.
31 terms
Medical Office Billing Process
Accounting Cycle
Accounts Receivable(AR)
Adjudication
Billing Cycle
Flow of financial transactions in a business.
Monies that are flowing IN to a business.
Series of steps that determine whether a claim should be paid.
Regular schedule of sending statements to patients.
Accounting Cycle
Flow of financial transactions in a business.
Accounts Receivable(AR)
Monies that are flowing IN to a business.
32 terms
Medical Office Billing Process
Accounting Cycle
Accounts Receivable(AR)
Adjudication
Billing Cycle
Flow of financial transactions in a business.
Monies that are flowing IN to a business.
Series of steps that determine whether a claim should be paid.
Regular schedule of sending statements to patients.
Accounting Cycle
Flow of financial transactions in a business.
Accounts Receivable(AR)
Monies that are flowing IN to a business.
10 terms
Medical Billing Process
#1 Preregister Patients
#2 Establish financial responsibility
#3 Check in Patients
#4 Check out Patient
Gather information so patients can be preregistered before th…
important to ask patient if covered by insurance, if so fined…
when a patient arrives additional information is needed. The…
a physician evaluates and treats a patient's condition this i…
#1 Preregister Patients
Gather information so patients can be preregistered before th…
#2 Establish financial responsibility
important to ask patient if covered by insurance, if so fined…
32 terms
Medical Office Billing Process
Accounting Cycle
Accounts Receivable(AR)
Adjudication
Billing Cycle
Flow of financial transactions in a business.
Monies that are flowing IN to a business.
Series of steps that determine whether a claim should be paid.
Regular schedule of sending statements to patients.
Accounting Cycle
Flow of financial transactions in a business.
Accounts Receivable(AR)
Monies that are flowing IN to a business.
29 terms
The Medical Office BIlling Process
Accounting Cycle
Accounts Receivable (AR)
Adjudication
Billing Cycle
The flow of financial transactions in a business.
Monies that are flowing into a business.
Series of steps that determine whether a claim should be paid.
Regular schedule of sending statements to patients.
Accounting Cycle
The flow of financial transactions in a business.
Accounts Receivable (AR)
Monies that are flowing into a business.
33 terms
Medical Billing/Claims Processing
Paper claims
electronic claims
patient's information
claim denials
claims printed on paper and submitted to the insurance carrie…
claims are sent to the insurance carrier via internet. takes…
should always be verified prior to services being rendered
duplicate claims, claim lacks information, eligibility expire…
Paper claims
claims printed on paper and submitted to the insurance carrie…
electronic claims
claims are sent to the insurance carrier via internet. takes…
21 terms
Introduction to the Medical Billing Process
Benefits
Capitation
Coinsurance
Deductible
payments for medical services
Payment to a provider that covers each plan member's health c…
Percentage of charges that an insured person must pay for hea…
Amount due that insured pays on covered services before benef…
Benefits
payments for medical services
Capitation
Payment to a provider that covers each plan member's health c…
10 terms
Medical Insurance Steps to Billing Process
Step 1
Step 2
Step 3
Step 4
preregister patients
establish financial responsibility
check in patients
check out patients
Step 1
preregister patients
Step 2
establish financial responsibility
10 terms
Medical Insurance Steps to Medical Billing Process
Step 1
Step 2
Step 3
Step 4
preregister patients
establish financial responsibility
check in patients
review coding compliance
Step 1
preregister patients
Step 2
establish financial responsibility
10 terms
10 Steps to the Medical Billing Process
Step 1
Step 2
Step 3
Step 4
Preregister Patients
Establish Financial Responsibility for the visit.
Check in Patients
Check out Patients
Step 1
Preregister Patients
Step 2
Establish Financial Responsibility for the visit.
10 terms
Chapter 1-3 Medical Insurance Steps to Medical Billing Process
Step 1
Step 2
Step 3
Step 4
preregister patients
establish financial responsibility
check in patients
check out patients
Step 1
preregister patients
Step 2
establish financial responsibility
435 terms
Medical Billing & Coding set
abdomin/o
-agon
-22
When should an ABN be signed?
abdomen
assemble
Increase procedural services
When a service is not expected to be covered by Medicare.
abdomin/o
abdomen
-agon
assemble
45 terms
Medical Billing Specialist (CMBS) and Medical Record Tech (CMRT): Billing Process
What is Medical Billing?
When does the billing process begin?
What should the patient bring with the…
Prior to the appointment it is importa…
The process of collecting fees for medical services rendered…
When the patient calls to make the appointment
* Insurance card... * Photo identification card... * Co-pay and ded…
Insurance benefits for new patients and for those patients wh…
What is Medical Billing?
The process of collecting fees for medical services rendered…
When does the billing process begin?
When the patient calls to make the appointment
10 terms
Chapter 1-3 Medical Insurance Steps to Medical Billing Process
Step 1
Step 2
Step 3
Step 4
preregister patients
establish financial responsibility
check in patients
check out patients
Step 1
preregister patients
Step 2
establish financial responsibility
10 terms
Chapter 1-3 Medical Insurance Steps to Medical Billing Process
Step 1
Step 2
Step 3
Step 4
preregister patients
establish financial responsibility
check in patients
check out patients
Step 1
preregister patients
Step 2
establish financial responsibility
10 terms
Chapter 1-3 Medical Insurance Steps to Medical Billing Process
Step 1
Step 2
Step 3
Step 4
preregister patients
establish financial responsibility
check in patients
check out patients
Step 1
preregister patients
Step 2
establish financial responsibility
10 terms
MS126FP Medical Insurance Steps to Medical Billing Process
Step 1
Step 2
Step 3
Step 4
preregister patients
establish financial responsibility
check in patients
check out patients
Step 1
preregister patients
Step 2
establish financial responsibility
10 terms
Chapter 1-3 Medical Insurance Steps to Medical Billing Process
Step 1
Step 2
Step 3
Step 4
preregister patients
establish financial responsibility
check in patients
check out patients
Step 1
preregister patients
Step 2
establish financial responsibility
45 terms
Medical Coding and Billing ICD-10-Scatter Set
The Coding Notation that adds further…
Synonyms, alternate words, and explana…
Septicemia due to unknown causes
Encephalitis due to Measles
Includes
[ ] Brackets
A41.9
B05.0
The Coding Notation that adds further…
Includes
Synonyms, alternate words, and explana…
[ ] Brackets
20 terms
Bill of Rights + Due Process Study Set
1st Amendment
2nd Amendment
3rd Amendment
4th Amendment
Freedom of religion, speech, the press, assembly, and the rig…
Right to Bear Arms
You don't have to Quarter Soldiers
No unreasonable Searches and Seizures
1st Amendment
Freedom of religion, speech, the press, assembly, and the rig…
2nd Amendment
Right to Bear Arms
64 terms
Advanced Settings - Medical Terminology (Bill Ross)
Abrasion
Acute
Acute myocardial infarction
Analgesic
Scrape of the skin due to something abrasive
Having a rapid onset
Insufficient blood flow to the heart muscle often resulting i…
Pain reliever
Abrasion
Scrape of the skin due to something abrasive
Acute
Having a rapid onset
35 terms
Advanced Settings - Medical Disciplines (Bill Ross)
Anesthesiology
Angiology
Audiology
Bacteriology
Medical specialty dealing with relief of pain and administrat…
Study of blood vessels and lymph vessels
The branch of medical science that studies hearing, especiall…
Scientific study of bacteria
Anesthesiology
Medical specialty dealing with relief of pain and administrat…
Angiology
Study of blood vessels and lymph vessels
68 terms
medical billing
`Reimbursement specialist
The document submitted to the payer re…
The center for medicare and medicaid s…
A healthcare practitioner is also call…
an other name for health insurance specialist
Health insurance claim.
Department of health and human services
provider
`Reimbursement specialist
an other name for health insurance specialist
The document submitted to the payer re…
Health insurance claim.
38 terms
Medical Billing
Accept assignment
Accounts receivable
Accounts receivable aging report
Allowed charges
Provider accepts as payment in full whatever is paid on the c…
The amount owed to a business for services or goods provided
Shows the status of outstanding claims from each payer, as we…
The maximum amount the payer will reimburse for each procedur…
Accept assignment
Provider accepts as payment in full whatever is paid on the c…
Accounts receivable
The amount owed to a business for services or goods provided
26 terms
Medical billing part 3
American Academy of Professional Coder…
American Health Information Management…
American Medical Billing Association (…
Centers for Medicare and Medicaid Serv…
Professional association established to provide a national ce…
Founded in 1928 to improve the quality of medical records and…
Offers the Certified Medical Reimbursement Specialists (CMRS)…
Formerly known as the Health Care Financing Administration (H…
American Academy of Professional Coder…
Professional association established to provide a national ce…
American Health Information Management…
Founded in 1928 to improve the quality of medical records and…
41 terms
Medical billing part 2
Abuse
Authorization
Breach of confidentiality
Case law
Actions inconsistent with accepted, sound medical, business o…
Document that provides official instruction, such as the cust…
Unauthorized release of patient information to a third party
Also called common law: based on a court decision that establ…
Abuse
Actions inconsistent with accepted, sound medical, business o…
Authorization
Document that provides official instruction, such as the cust…
126 terms
Medical Billing and Coding Final
What is a rule of conduct established…
Another name for terminating care of a…
A health-care professional who stops c…
The appropriate way for a physician to…
Law
D) withdrawing from a case
D) abandonment
Send the patient a certified letter
What is a rule of conduct established…
Law
Another name for terminating care of a…
D) withdrawing from a case
45 terms
Introduction to Medical Billing & Coding
WHO
ICD
Who developed ICD to:
CPT
World Health Organization
International Classification of Diseases
collect data for statistical purposes
Current Procedural Terminiology
WHO
World Health Organization
ICD
International Classification of Diseases
30 terms
Medical Billing & Coding Module 2
Primary Insurance
Secondary Insurance
Encounter Form
Claims Submission
is the insurance plan responsible for paying health care insu…
is the insurance plan that is billed after the primary insura…
is the financial record source document used by health care p…
is the electronic or manual transmission of claims data to pa…
Primary Insurance
is the insurance plan responsible for paying health care insu…
Secondary Insurance
is the insurance plan that is billed after the primary insura…
347 terms
Medical Billing/Coding Terms - combined lists
(Medi-Medi)
(nonpar)
Abuse
Abuse
Refers to an individual who receives medical or disability be…
A provider who decides not to accept the determined allowable…
were doctors charge PRIVATE insurance subscribers extra for o…
incidents or practices, not usually considered fraudulent, bu…
(Medi-Medi)
Refers to an individual who receives medical or disability be…
(nonpar)
A provider who decides not to accept the determined allowable…
347 terms
Medical Billing/Coding Terms - combined lists
(Medi-Medi)
(nonpar)
Abuse
Abuse
Refers to an individual who receives medical or disability be…
A provider who decides not to accept the determined allowable…
were doctors charge PRIVATE insurance subscribers extra for o…
incidents or practices, not usually considered fraudulent, bu…
(Medi-Medi)
Refers to an individual who receives medical or disability be…
(nonpar)
A provider who decides not to accept the determined allowable…
Medical Billing Insurance Test 2 Review @ LIBI
MCR
MCD
allowed amount
Part A
medicare
medicaid
the amount deemed appropriate to pay for svcs rendered by an…
covers hospital
MCR
medicare
MCD
medicaid
30 terms
Medical Billing & Coding Module 2
Primary Insurance
Secondary Insurance
Encounter Form
Claims Submission
is the insurance plan responsible for paying health care insu…
is the insurance plan that is billed after the primary insura…
is the financial record source document used by health care p…
is the electronic or manual transmission of claims data to pa…
Primary Insurance
is the insurance plan responsible for paying health care insu…
Secondary Insurance
is the insurance plan that is billed after the primary insura…
30 terms
Medical Billing & Coding Module 8
Medicare Part A
Medicare Part B
Medicare Hospital Insurance (Medicare…
Medicare Advantage (Medicare Part C)
reimburses institutional providers for inpatient, hospice, an…
reimburses institutional providers for outpatient services an…
pays for inpatient hospital critical care access; skilled nur…
formerly called Medicare+Choice, includes managed care and pr…
Medicare Part A
reimburses institutional providers for inpatient, hospice, an…
Medicare Part B
reimburses institutional providers for outpatient services an…
69 terms
Medical Billing Ch. 15 Patient Billing and Collections
Patient billing and collections, last…
Patient Financial Responsibility - def…
Policies should handle:
Effective patient billing includes:
- Generating and mailing patient statements showing patient b…
- financial arrangements & payment plans... - payments not cove…
- collection of copayments, deductibles & past-due balances…
educating patinets from the start of the billing & reimbursem…
Patient billing and collections, last…
- Generating and mailing patient statements showing patient b…
Patient Financial Responsibility - def…
- financial arrangements & payment plans... - payments not cove…
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.
126 terms
Medical Billing and Coding Final
What is a rule of conduct established…
Another name for terminating care of a…
A health-care professional who stops c…
The appropriate way for a physician to…
Law
D) withdrawing from a case
D) abandonment
Send the patient a certified letter
What is a rule of conduct established…
Law
Another name for terminating care of a…
D) withdrawing from a case
Medical Billing Theory Final Review
How many types of release forms are th…
Encounter Form/Superbill
Copayment
Demographics
there are three: medical, telephone, HIV/AIDS
form used by the physician to select frequently used CPT-4 &…
small fee paid upon every office visit
term used to identify all pt info. necessary for all forms
How many types of release forms are th…
there are three: medical, telephone, HIV/AIDS
Encounter Form/Superbill
form used by the physician to select frequently used CPT-4 &…
45 terms
Medical Coding and Billing ICD-10
The Coding Notation that adds further…
Synonyms, alternate words, and explana…
Septicemia due to unknown causes
Encephalitis due to Measles
Includes
[ ] Brackets
A41.9
B05.0
The Coding Notation that adds further…
Includes
Synonyms, alternate words, and explana…
[ ] Brackets
14 terms
Intro to Medical Billing
account aging
balance due
bankruptcy
claim message
The process of finding out how long specific account balances…
Total amount owed.
Legal process by which the debts of an individual or business…
Messages encouraging payment of a bill, usually attached to o…
account aging
The process of finding out how long specific account balances…
balance due
Total amount owed.
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…
30 terms
Medical Billing & Coding Module 5
Orthotics
Prosthetics
HCPCS Level II Temporary Codes
Ambulatory Surgical Center (ASC)
is a branch of medicine that deals with the design and fittin…
is a branch of medicine that deals with the design, productio…
are maintained by the CMS and other members of the HCPCS Nati…
is a state-licensed, Medicare-certified supplier (not provide…
Orthotics
is a branch of medicine that deals with the design and fittin…
Prosthetics
is a branch of medicine that deals with the design, productio…
30 terms
Medical Billing & Coding Module 8
Medicare Part A
Medicare Part B
Medicare Hospital Insurance (Medicare…
Medicare Advantage (Medicare Part C)
reimburses institutional providers for inpatient, hospice, an…
reimburses institutional providers for outpatient services an…
pays for inpatient hospital critical care access; skilled nur…
formerly called Medicare+Choice, includes managed care and pr…
Medicare Part A
reimburses institutional providers for inpatient, hospice, an…
Medicare Part B
reimburses institutional providers for outpatient services an…
342 terms
Medical Assistant Medical Billing/Coding Terms - combined lists
(Medi-Medi)
(nonpar)
abuse
Abuse
Refers to an individual who receives medical or disability be…
A provider who decides not to accept the determined allowable…
were doctors charge PRIVATE insurance subscribers extra for o…
incidents or practices, not usually considered fraudulent, bu…
(Medi-Medi)
Refers to an individual who receives medical or disability be…
(nonpar)
A provider who decides not to accept the determined allowable…
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.
33 terms
Medical Billing Mod 1 Chapt 1
accounting cycle
accounts receivable (AR)
adjustication
capitation
the flow of financial transactions in a business
monies that are flowing into a business
series of steps that determine whether a claim should be paid
payment to a provider that covers each plan memeber's health…
accounting cycle
the flow of financial transactions in a business
accounts receivable (AR)
monies that are flowing into a business
46 terms
NHA MED TERM SUFFIXES & PREFIXES FOR MEDICAL BILLING
-algia
-emia
-itis
-megaly
pain
blood condition
inflammation
enlargement
-algia
pain
-emia
blood condition
17 terms
Medical Billing (Chapter 2/Key Terms)
adjustments
aging
ancillary charges
(CDM) charge description master
An amount (+ or -) entered in a billing program to change an…
The classification of accounts receivable by the amount of ti…
Fee for services other than room and board provided during a…
A hospital's list of codes and charges for its services.
adjustments
An amount (+ or -) entered in a billing program to change an…
aging
The classification of accounts receivable by the amount of ti…
12 terms
Medical Billing (Chapter 3/Key Terms)
(COB) coordination of benefits
(FI) fiscal intermediary
Medicare Part A
Medicare Part B
A clause in an insurance policy that explains how the policy…
A government contractor that processes claims for Medicare Pa…
The part of the Medicare program that pays for hospitalizatio…
The part of the Medicare program that pays for physician serv…
(COB) coordination of benefits
A clause in an insurance policy that explains how the policy…
(FI) fiscal intermediary
A government contractor that processes claims for Medicare Pa…
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