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Medical Coding
Chapter 1
Question | Answer |
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Benefits | The amount of money a health plan pays for services covered in an insurance policy. |
Capitation | Payment method in which a prepayment covers the provider's services to a plan memeber for a specified period of time. |
Centers for Medicare and Medicaid Services (CMS) | Federal agency within the department of Health and Human Services that runs Medicare, Medicaid, Clinical Laboratories (under the CLIA program) and other governmental health programs. |
Coinsurance | The portion of charges that an insured person must pay for health care services after payment of the deductible amount; usually sated as a percentage. |
Consumer-Driven Health Plan | Type of employment-sponsored medical insurance that combines a high deductible plan with a medical savings plan that covers some out-of-pocket expenses. |
Copayment | an amount that a health plan requires a beneficiary to pay at the time of services for each health care encounter. |
Credentialing | The process of periodic verification that a provider or facitlity meets the professional standards of a certifying organization. Physician credentialing involves screening and evaluating qualifications and other credentials, including licensure, required |