Dr Madhu S&T3
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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| Assignment of Benefits | Transferring the right to collect payments from a insurance company from the patient to the doctor
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| Beneficiary | Person entitled to recieve benefits also called participant, subscriber dependent enrollee, or member.
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| Employer Indentification Number (EIN) | Number used by the IRS to identify a business for income tax reporting
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| Medigap | a term sometimes applied to private insurance products that supplements Medicare insurance benefits
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| Universal Claim Form | A form made by the Health Care financing Administration (now CMSI center for Medicare and Medicaid Services) used to submit all government sponsored claims
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| Allowed Charge | the most amount of money allowed for a procedure or service
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| Authorization | An approval for a procedure or referral
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| Utilization Review | When a case is reviewed to see if services are really needed and how medical resources are used.
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| Managed Care Plans | A term used for all healthcare plans that provide healthcare in return for a monthly fee using a set group of primary care doctors and hospitals
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| Medical Indigent | Someone who can pay for normal daily living expenses but cannont afford adequate health care.
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| Premium | the monthly, quarterly or annual payment of money to an insurance company for providing certain benefits
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| co-payment | The amount paid at the time of medical service
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| deductible | amount that must be paid out of pocket before the insurance company begins to pay
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| disability income insurance | insurance that provides money to replace income when someone is unable to work because of an illness, injury, or disease
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| exclusions | things (diseases, conditions) on an insurance contract for which benefits are not paid.
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| group policy | insurance that covers a group of people with a single contract usually through their employer
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| Worker's Compensation | Insurance against liability employer pay to give benefits to workers who are injured or killed on the JOB.
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| Clean Claim | An insurance claim form without ERRORS or Omissions
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| Dingy Claim | A claim that is delayed because it cannot be process
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| Dirty Claim | Claims that contain errors or omissions that cannot be processed or must be processed by hand
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| COB | Coordination of Benefits
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| HIPAA | Health Insurance Portability Accountability Act
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| HMO | Health Maintenace Organization
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| PAR | Participating Provider
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| RBRVS | Resurce Based Relative Value Systems
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