Study sets matching "medical coding and billing insurance icbs 120 combining"
Study sets
Diagrams
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…
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…
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…
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
Allowable charge/fee or Maximum allowab…
Blue Cross and Blue Shield Association…
Blue Cross/ Blue Shield
Cafeteria plan
The payment to the provider that is the lower amount of the pr…
The combined Board of Directors from the Blue Cross program an…
A nationwide federation of nonprofit health insurance companie…
A health insurance plan that allows beneficiaries to choose co…
Allowable charge/fee or Maximum allowab…
The payment to the provider that is the lower amount of the pr…
Blue Cross and Blue Shield Association…
The combined Board of Directors from the Blue Cross program an…
Accounts Payable (AP)
Accounts Receivable (AR)
Adjudication
Benefits
Money owed by a company to its creditors
Money owed to a company by its debtors
a formal judgment on a disputed matter
Payments for medical services
Accounts Payable (AP)
Money owed by a company to its creditors
Accounts Receivable (AR)
Money owed to a company by its debtors
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
Health Insurance Claim
Healthcare Provider
Health Insurance Specialist/Reimburseme…
Claims Examiner
documentation submitted to a 3rd party payer requesting reimbu…
physician or other healthcare practitioner "PA"
review health related claims to determine necessity
reviews health related claims, to determine if charges are rea…
Health Insurance Claim
documentation submitted to a 3rd party payer requesting reimbu…
Healthcare Provider
physician or other healthcare practitioner "PA"
Premium
Deductible
Copay
Co-insurance
Money the insured pays to health plan for healthcare policy
An amount that an insured person must pay usually on an annual…
Specified amount a beneficiary must pay at the time of a healt…
The portion of charges that an insured person must pay for hea…
Premium
Money the insured pays to health plan for healthcare policy
Deductible
An amount that an insured person must pay usually on an annual…
Black Lung Program or Federal Coal Mine…
CA-7 Claim Form for Compensation
Combination program
Commercial workers' compensation program
Act that provide benefits to coal miners.
A workers' compensation program claims submission form.
A combination of state, employer self-insured and commercial w…
Program in which employers purchase insurance policies that pr…
Black Lung Program or Federal Coal Mine…
Act that provide benefits to coal miners.
CA-7 Claim Form for Compensation
A workers' compensation program claims submission form.
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
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
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
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
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…
Which of the following laws is designed…
A Notice of Privacy Practices is given…
Which government group has the authorit…
Patients always have the right to...
HIPAA
A practice's patients
OCR
withdraw their authorization to release information
Which of the following laws is designed…
HIPAA
A Notice of Privacy Practices is given…
A practice's patients
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…