Chapters 1&2 UHI
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| CMS | Centers for Medicare and Medicaid Services
🗑
|
||||
| health care provider | A physician or other health care practitioner
🗑
|
||||
| health insurance claim | documentation submitted to an insurance plan requesting reimbursement for services provided
🗑
|
||||
| explanation of benefits | report that details the results of processing a claim, sent to the policyholder
🗑
|
||||
| remittance advice | electronic or paper report sent by insurance company to the physician that details the result of the claim
🗑
|
||||
| balance billing | billing patients for amounts not reimbursed by the insurance [lan
🗑
|
||||
| hold harmless clause | policy clause that holds that the patient is not responsible for paying what the insurance plan denies
🗑
|
||||
| independent contractor | a person who performs services for another under an express agreement and who is not subject to the other's control
🗑
|
||||
| medical necessity | linking every procedure code on an insurance claim to a diagnosis code that justifies the need to perform it
🗑
|
||||
| preauthorization | preapproval for services
🗑
|
||||
| respondeat superior | "let the master answer"; the employer is responsible for the actions/inactions of their employees
🗑
|
||||
| Medical Biller | The person responsible for submitting a provider’s charges to the appropriate party.
🗑
|
||||
| Clearinghouse | An offsite company hired to process medical bills for the physician, and to convert paper claims into electronic format.
🗑
|
||||
| claims examiner | Employed by aninsurance company; reviews health-related claims to determine whether the charges are reasonable and meet the criteria for medical necessity.
🗑
|
||||
| Health Insurance | A contract between the subscriber and the insurance company to pay for all or part of medical care and preventive services.
🗑
|
||||
| Disability Insurance | Insurance providing income to a policyholder who is temporarily or permanently disabled and cannot work.
🗑
|
||||
| Liability Insurance | Covers losses to a third party caused by the insured, an object owned by the insured, or on property owned by the insured.
🗑
|
||||
| Worker’s Compensation | Federal and state legislation that requires employers to cover medical expenses and lost wages for workers injured on the job.
🗑
|
||||
| Professional Liability Insurance | For independent contractors, it provides protection from any expenses (penalties) from errors and/or omissions from claims submissions.
🗑
|
||||
| Bonding insurance | Guarantees repayment for financial losses resulting from an employee’s act or failure to act.
🗑
|
||||
| Medical Care | The identification of disease, and the care and treatment to persons that are sick and injured.
🗑
|
||||
| Health care | Medical Care plus Preventive Services
🗑
|
||||
| policyholder | Person who signs a contract with the insurance company – “owns” the policy
🗑
|
||||
| Third-party payer | A healthcare insurance company
🗑
|
||||
| Group Health Insurance | Health insurance coverage subsidized by employers and other organizations.
🗑
|
||||
| Individual Health Insurance | Private health insurance policy purchased by individuals or families
🗑
|
||||
| Single-payer plan | Centralized healthcare system adopted by some nations (Canada, U.K.) and funded by taxes. The government pays for each resident’s health care, which is considered a basic social service.
🗑
|
||||
| Socialized medicine | A type of single-payer system in which the government owns and operates healthcare facilities and providers receive salaries.
🗑
|
||||
| Universal Health Insurance | The goal of providing every individual with access to health coverage
🗑
|
||||
| Hill-Burton Act | Provided grants to modernize hospitals. In return, hospitals must provide services to patients who are unable to pay for care at free or reduced costs
🗑
|
||||
| COBRA | Federal legislation that allows employees to continue health care insurance beyond their termination date.
🗑
|
||||
| DRG | Diagnosis-related group; Prospective (pre-determined) payment system that reimburses hospitals for in-patient stays
🗑
|
||||
| ARRA/HITECH | Legislation that provides incentives to physicians that have a “meaningful use of EHRs”
🗑
|
||||
| PPACA | Patient Protection and Affordable Care Act
🗑
|
||||
| medical record | documents healthcare services provided to a patient
🗑
|
||||
| Continuity of care | involves documenting patient care services so that others who treat the patient have a source of information to assist with additional care and treatment
🗑
|
||||
| Problem-Oriented Record | Systematic method of documentation consists of four components:Database, Problem list, Initial plan, Progress notes
🗑
|
||||
| SOAP | Subjective, Objective, Assessment, Plan
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
Kirkster
Popular Medical sets