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med. billing part
medical billing chapter 1 part 1
Question | Answer |
---|---|
Accounting cycle | flow of financial transactions in a business |
Accounts receivable (AR) | term used to describe money coming in to a business |
Capitation | a fixed amount that is paid to a provider in advance to provide medically necessary services to patients |
Coinsurance | Under an insurance plan, the portion or percentage of the charges that the patient is responsible for paying |
Co-payment | a small fixed fee paid by the patient at the time of an office visit |
Diagnosis code | a value that stands for a patient's illness, signs, or symptoms |
Encounter form | a form listing procedures relevant to the specialty of a medical office, used to record the procedures |
Explanation of beneifts (EOB) | document form a health plan that list the amount of a benefit and explains how it was determined |
Fee-for-service | insuramce plan in which policyholders are reimbursed for health care cost |
Health maintenance organization (HMO) | type of managed care system in which providers are paid fixed rates at regular intervals |
Health plan | a plan, program, or organization that provides health benefits |
Managed care | a type of insurance in which the carrier is responsible for the financing and delivery of health care. |
Ploicy holder | individual who has contracted with a health plan for coverage. |
Preferred provider organization (PPO) | a network of health care providers who agree to provide services to plan members at a discounted fee |
Premium | payment made to a health plan by policyholder for coverage |
Procedure code | a number that represents medical procedures performed by aprovider |
Remittance advice (RA) | an electronic document from a health plan that lists the amount of benefit and explains how it was determined. |