Additional for Chapter 4 - HI
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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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)
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the insurance plan responsible for paying health insurance claims first | primary insurance
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policyholder whose birth month and day occurs earlier in the calendar year holds the primary policy for dependent children | birthday rule
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what a superbill is called in the hospital | chargemaster
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set of supporting documentation or information associated with a health care claim or patient encounter | claims attachment
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payers deposit funds to the provider's account electronically | electronic funds transfer
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the routing slip, charge slip, encounter form, or superbill from which the insurance claim was generated | source document
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submitted to carrier, but not paid yet | open claims
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all processing, including appeals, has been completed | closed claims
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assigning lower-level codes than documented in the record | downcoding
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collectors may not harrass debtors | Fair Debt Collection Practices Act
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Created by:
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