Intro to medical billing
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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| The identification of disease, and the care and treatment to persons that are sick or injured | medical care
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| medical care plus preventive services | health care
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| a contract between the subscriber and the insurance company to pay for all or part of health care | health insurance
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| Insurance providing income to a policyholder who is temporarily or permanently disabled and cannot work | disability insurance
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| covers losses to a third party caused by the insured or property of the insured; covers medical care, lost wages and pain/suffering | liability insurance
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| Federal legislation that requires employers to cover medical expenses and lost wages for workers injured on the job | Workers compensation
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| Federal legislation that allows employees to continue health care beyond their termination date - must pay premiums | COBRA
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| Provided grants to modernize hospitals; in return, hospitals must provide care to those in need at free or reduced cost | Hill-Burton Act
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| A physician or other health care practitioner | provider
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| A provider who has signed a contract with an insurance company; agrees to accept what insurance pays as payment in full | participating provider
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| A provider who is not under contract with an insurance company; is allowed to charge patient the difference between charge and reimbursement | nonparticipating provider
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| The person who has the insurance policy - in their name | policyholder
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| a person covered under a policyholder's insurance plan | dependent
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| a person responsible for paying the patient's account | guarantor
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| A patient without health insurance that must pay out of pocket for care. | self-pay
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| The insurance plan that is billed first | primary insurance
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| the insurance plan that is billed second | secondary insurance
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| States that the plan of the policyholder whose birth day and month comes first in year is primary | Birthday rule
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| The provider accepts as payment in full what the insurance pays. | Accept assignment
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| The patient gives permission for payment to be sent to the provider. | Assignment of Benefits
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| The amount the patient is responsible for paying before any reimbursement is issued by the insurance policy | deductible
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| A percentage the patient is responsible to pay of the cost of medical services. | coinsurance
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| a flat fee the patient pays each time for medical services | copayment
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| The dollar amount an insurance company deems fair for a specific service or procedure | allowed charge
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| Determines the allowed charge; based on physician work, practice expense, and malpractice insurance costs | RBRVS
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| A list of allowed charges for all services and procedures payable by the insurance company | fee schedule
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| Hospitalization, labs, x-rays, surgical fees, OB care, newborn care, intensive care, chemo | Basic coverage
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| office visits, outpatient, PT and OT, DME, mental health, allergy testing, Rx drugs | Major medical
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| Any condition that was diagnosed and/or treated before a patient's effective date of their insurance policy | preexisting condition
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| Paper form used to file medical claims for physician and outpatient services | CMS 1500
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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.
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Created by:
Kirkster
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