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P Mylin Study Stack

Additional for Chapter 4 - HI

does not contract with the insurance plan, and patients who elect to receive care from nonPARs will incur higher out-of-pocket expenses non-participating provide (nonPAR)
the insurance plan responsible for paying health insurance claims first primary insurance
policyholder whose birth month and day occurs earlier in the calendar year holds the primary policy for dependent children birthday rule
what a superbill is called in the hospital chargemaster
set of supporting documentation or information associated with a health care claim or patient encounter claims attachment
payers deposit funds to the provider's account electronically electronic funds transfer
the routing slip, charge slip, encounter form, or superbill from which the insurance claim was generated source document
submitted to carrier, but not paid yet open claims
all processing, including appeals, has been completed closed claims
assigning lower-level codes than documented in the record downcoding
collectors may not harrass debtors Fair Debt Collection Practices Act
Created by: pmylin