Quiz 3
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| computer-assisted coding (CAC) | Software that scans the entire patient's electronic record and codes based on the documentation in the record
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| conditional payment | Medicare payment that is recovered after primary insurance pays
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| contractual obligation | Used when a contractual agreement resulted in an adjustment
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| coordination of benefits rules | Determines which insurance plan is primary and which is secondary
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| cost sharing | The balance the policyholder must pay to the provider
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| crossover claim | Claim submitted by people covered by a primary and secondary insurance plan
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| deidentified information | Information that does not identify an individual because unique and personal characteristics have been removed
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| demographic information | Date of birth, sex, marital status address, telephone number, relationship to subscriber, and circumstances of condition
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| description of service | An evaluation and management visit, observation, or emergency room visit
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| diagnosis code | International Classification of Diseases (ICD-9-CM volumes 1 and 2; ICD-10-CM)
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| dirty claim | Claim that is inaccurate, incomplete, or contains other errors
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| E codes | Codes used to classify environment events, circumstances, and conditions, such as the cause of injury, poisoning, and other adverse events. Specific to ICD-9-CM
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| electronic data interchange (EDI) | The transfer of electronic information in standard formation
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| employer-based self-insurance | Insurance that is tied to an individual's place of employment
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| encoder | Software that suggests codes based on documentation or other input
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| encounter form | Form that includes information about past history, current history, inpatient record, discharge information, and insurance information
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| explanation of benefits (EOB) | Describes the services rendered, payment covered, and benefits limits and denials
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| consent | A patient's permission evidenced by signature
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| encounter | A direct, professional meeting of a patient and health care professional who is licensed to provide medical service
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| correction and renewal | Used for correcting a prior claim
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Created by:
sbogle
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