Study sets matching "medical coding and billing insurance icbs 120 combining"
Study sets
Classes
Users
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 practic…
Cash Flow
movement of monies into or out of a business.
Accounts Receivable (AR)
monies owed to a medical practice.
Medicare Part A
Medicare Part B
Medicare Hospital Insurance (Medicare P…
Medicare Advantage (Medicare Part C)
reimburses institutional providers for inpatient, hospice, and…
reimburses institutional providers for outpatient services and…
pays for inpatient hospital critical care access; skilled nurs…
formerly called Medicare+Choice, includes managed care and pri…
Medicare Part A
reimburses institutional providers for inpatient, hospice, and…
Medicare Part B
reimburses institutional providers for outpatient services and…
A. Credit
D. Member contract
B. An insurance claims register
B. The NPI of the provider who provided…
A patient has paid in advance and the third-party payer paid m…
Secondary to the CMS-1500 claim form, which of the following f…
To ensure all claims are being submitted and received, a billi…
Which of the following describes the billing provider NPI?... A.…
A. Credit
A patient has paid in advance and the third-party payer paid m…
D. Member contract
Secondary to the CMS-1500 claim form, which of the following f…
Medicare Part A
Medicare Part B
Medicare Hospital Insurance (Medicare P…
Medicare Advantage (Medicare Part C)
reimburses institutional providers for inpatient, hospice, and…
reimburses institutional providers for outpatient services and…
pays for inpatient hospital critical care access; skilled nurs…
formerly called Medicare+Choice, includes managed care and pri…
Medicare Part A
reimburses institutional providers for inpatient, hospice, and…
Medicare Part B
reimburses institutional providers for outpatient services and…
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 practic…
Cash Flow
movement of monies into or out of a business.
Accounts Receivable (AR)
monies owed to a medical practice.
Accounts Payable (AP)
Accounts Receivable (AR)
Adjudication
Benefits
a practices operating expenses.
monies owed to a medical practice.
health plan process of examining claims and determining benefi…
health plan payments for covered services.
Accounts Payable (AP)
a practices operating expenses.
Accounts Receivable (AR)
monies owed to a medical practice.
Health Maintenance Organization (HMO)
Etiquette
Schedule of benefits
Fee-for-service
managed health care system in which providers offer healthcare…
standards for professional behavior
list of medical expenses covered by a health plan.
payment method based on provider charges.
Health Maintenance Organization (HMO)
managed health care system in which providers offer healthcare…
Etiquette
standards for professional behavior
Alphabetic Index
Approach
Benign
Body system
= Component of the ICD-9 ad ICD-10 coding references; an alpha…
= The technique or a method used to reach a given procedure si…
Noncancerous
The general physiological system or anatomic region involved i…
Alphabetic Index
= Component of the ICD-9 ad ICD-10 coding references; an alpha…
Approach
= The technique or a method used to reach a given procedure si…
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 practices operating expenses
process of making sure sufficient monies flow into the practic…
cash flow
movement of monies into or out of a business
accounts receivable (AR)
monies owed to a medical practice
A. Credit
D. Member contract
B. An insurance claims register
B. The NPI of the provider who provided…
A patient has paid in advance and the third-party payer paid m…
Secondary to the CMS-1500 claim form, which of the following f…
To ensure all claims are being submitted and received, a billi…
Which of the following describes the billing provider NPI?... A.…
A. Credit
A patient has paid in advance and the third-party payer paid m…
D. Member contract
Secondary to the CMS-1500 claim form, which of the following f…
advance beneficiary notice of noncovera…
benefit period (Medicare)
conditional primary payer status
coordinated care plan
document that acknowledges patient responsibility for payment…
begins with the first day of hospitalization and ends when the…
Medicare claim process that includes the following circumstanc…
also called managed care plan; includes health maintenance org…
advance beneficiary notice of noncovera…
document that acknowledges patient responsibility for payment…
benefit period (Medicare)
begins with the first day of hospitalization and ends when the…
cash flow
accounts receivable
AR
Accounts Payable
movement of monies into or out of a business
monies owed to a medical practice
Accounts Receivable
a practice's operating expenses
cash flow
movement of monies into or out of a business
accounts receivable
monies owed to a medical practice
Current Procedural Terminology
Category 1 Codes
Category 2 Codes
Category 3 Codes
Contains the standardized classification system for reporting…
Procedure codes found in the main body of CPT
Optional CPT codes that track performance measures
Temporary codes for emerging technology, services, and procedu…
Current Procedural Terminology
Contains the standardized classification system for reporting…
Category 1 Codes
Procedure codes found in the main body of CPT
(Medi-Medi)
(nonpar)
Abuse
Abuse
Refers to an individual who receives medical or disability ben…
A provider who decides not to accept the determined allowable…
were doctors charge PRIVATE insurance subscribers extra for on…
incidents or practices, not usually considered fraudulent, but…
(Medi-Medi)
Refers to an individual who receives medical or disability ben…
(nonpar)
A provider who decides not to accept the determined allowable…
Group health plan (GHP)
Rider
Carve out
Open enrollment period
Plan of an employer or employee organization to provide health…
Document modifying an insurance contract
Part of a standard health plan changed under an employer-spons…
Time when a policyholder selects from offered benefits
Group health plan (GHP)
Plan of an employer or employee organization to provide health…
Rider
Document modifying an insurance contract
SOAP
Subjective
Objective
Assessment
Subjective, objective,assessment, plan
Patients statement about how he or she feels, chief complaint
Observations about the patient , physical findings, labs or x…
Judgement opinion or evaluation made by the health care provid…
SOAP
Subjective, objective,assessment, plan
Subjective
Patients statement about how he or she feels, chief complaint
ABA routing number
Accounting
Accounts payable
Accounts receivable
A nine-digit number that identifies a bank; the number is prin…
Systemic recording and reporting of financial transactions.
The outstanding bills of business, such as a Medical Office.
Total amount owed to a business for goods and services.
ABA routing number
A nine-digit number that identifies a bank; the number is prin…
Accounting
Systemic recording and reporting of financial transactions.
Healthcare provider
Health Insurance Claim
CMS
Centers for Medicare and Medicaid Servi…
is a physician or other healthcare practitioner such as a phys…
is the documentation submitted to a third-party payer or gover…
is the administration agency within the federal Department of…
CMS
Healthcare provider
is a physician or other healthcare practitioner such as a phys…
Health Insurance Claim
is the documentation submitted to a third-party payer or gover…
clearinghouse
medical necessity
balance billing
code linkage
company that converts nonstandard transactions into standard t…
payment criterion that requires medical treatments to be appro…
collecting the difference between a providers usual fee and a…
connection between a service and a patient's condition or illn…
clearinghouse
company that converts nonstandard transactions into standard t…
medical necessity
payment criterion that requires medical treatments to be appro…
Alphabetic Index
Approach
Benign
Body system
Volume 3 lists diseases or conditions in alphabetical order
The technique or method used to reach a given procedure site
Noncancerous
The general physiological system or anatomical region involved…
Alphabetic Index
Volume 3 lists diseases or conditions in alphabetical order
Approach
The technique or method used to reach a given procedure site
Accounts payable (AP)
Accounts receivable (AR)
Adjudication
Cash Flow
-Practice's operating expenses... -Ex: Doctor paying employees, a…
-Monies owed to a medical practice... -Ex: Money owed by insuranc…
-Health plan process of examining claims and determining benef…
-Movement of monies into or out of a business... -Ex: comes in th…
Accounts payable (AP)
-Practice's operating expenses... -Ex: Doctor paying employees, a…
Accounts receivable (AR)
-Monies owed to a medical practice... -Ex: Money owed by insuranc…
Accounts payable
Accounts receivable
Cash flow
Adjudication
A practice's operating expenses
Monies owed to a medical practice
Movement of monies into or out of a business
Health plan process of examining claims and determining benefi…
Accounts payable
A practice's operating expenses
Accounts receivable
Monies owed to a medical practice
(Medi-Medi)
(nonpar)
Abuse
Abuse
Refers to an individual who receives medical or disability ben…
A provider who decides not to accept the determined allowable…
were doctors charge PRIVATE insurance subscribers extra for on…
incidents or practices, not usually considered fraudulent, but…
(Medi-Medi)
Refers to an individual who receives medical or disability ben…
(nonpar)
A provider who decides not to accept the determined allowable…
why do we care about billing and coding?
coding and billing involves ____ from i…
coding and billing is based on ____ of…
coding and billing helps in creating ri…
it is how we get paid for what we do ... (inpatient, outpatient,…
reimbursement
documentation
stratification
why do we care about billing and coding?
it is how we get paid for what we do ... (inpatient, outpatient,…
coding and billing involves ____ from i…
reimbursement