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Carnegie insurance f

commercial insurance final exam review and MA fall 2014

what is the purpose of workers compensation to provide medical care to injured employee, reimburse provided for services rendered to the injured employee, compensate employee with an income while recovering
what does workers compensation benefits include? Disability settlements, temporary disability income, rehabilitation and medical treatment
what is an explanation of benefits? explains what expenses were paid by the insurance company and sent to the physician's office
what is workers compensation? A type of insurance that protects workers from loss of wages
what is allowable or allowed amount? Max amount that a third-party payer will pay for services
what is a provider who has signed a contract with the insurance carrier called? Participating provider
what is the money the policyholder pays before the insurance company will start to pay on claims? The deductible
how many digits do CPT codes consist of? 5 digits
what is the name of health insurance for the spouses and dependence of uniformed military personnel? TRICARE
what is paid to keep the insurance policy in force? The premium
what should you get when verifying insurance? name of the contact person
How are hardcopy claims sent? US mail
how are electronic claims sent? Via the Internet directly to the insurance carrier is called direct billing
what does CPT mean? Current Procedural Terminology
what are claims that have errors or omissions that must be corrected called? Dirty
what must the position document on a work comp claim? Date, how and where the accident happened
what are the three types of disability claims? Non disability can return to work after being treated, NO WHERE clause temporary disability and permanent disability
how should you always start coding? in the alphabetical index
should you ever code from the alpha index alone? If not what should you do? no, you should always verify in the tabular index
what does AUDIT mean? to examine claims for accuracy and completeness before they are sent to the insurance carrier
how is verification of insurance done? By calling me insurance carrier or by going online to their website
Created by: ma2b