def bbv
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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| ABN | ADVANCE BENEFICIARY NOTICE
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| EOB | EXPLANATION OF BENEFITS
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| UCR | USUAL CUSTOMARY REASONABLE
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| RBRVS | RESOURCE-BASED RELATIVE VALUE
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| E & M | EVALUATION AND MANAGEMENT
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| Rt | RIGHT
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| Lt | LEFT
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| HTN | HYPERTENSION
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| FI | FISCAL INTERMEDIATE
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| Diag | DIAGNOSIS
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| UTI | URINARY TRACT INFECTION
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| OIG | OFFICE OF THE INSPECTOR GENERAL
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| HIPAA | HEALTH INSURANCE PORTABILITY ACCOUNTABILITY ACT
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| CMS | CENTERS FOR MEDICARE AND MEDICAID SERVICES
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| S/P | STATUS POST
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| ADVANCED BENEFICIARY NOTICE | a form stating that the service may not be covered must be signed in advanced before service is done
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| CHARGE TICKET | a document used by the practice to aid in insuring that correct codes are being used for billing and coding
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| OFFICE OF THE INSPECTOR GENERAL | has the authority to suspend exclude terminate and impose fines and penalties on providers, practitioners that commit fraud
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| FALSE CLAIMS ACT | a federal law that allow people not affiliated w/ the gov. to report fowl actions against federal contractor claiming fraud against the government fna the whislebloweres act
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| FRAUD | an intentional misrepersentation of the facts to deceive or mislead
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| ABUSE | incidents or practices, not usually considered fraudulent, that are inconsistent w/ accepted sound medical buniness or fical practices
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| JOINT COMMISSION ON THE ACCREDITATION OF THE HOSPITAL ORGANIZATION | requirements for reimbursment by a third-party carrier validates by quality of care and provide a competitive edge over facility that are not a credit.
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| WHISTLE BLOWERS PROTECTION ACT | ropart physicans suspected of defrauding the federal gov.
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| QUI TAM PROVISION | an action to recover a penalty brought on by an informer in a situation in which one portion of recovery goes to the informer and the other portion to the state or government
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| MANUEL REVIEW AND FLAG | all claims even those that are typicaly wiuld be processed automatically will be flaged if a practice or provider is found guilty of fraud.
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| LINE ITEM | represent one line of the claim
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| COMPLAINCE PROGRAM | a process of meeting regualtions, recommedations and expectations of federal and state agenies that pays for healtth service.
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| HEALTH INSURANCE PORTABLY AND ACCOUNTABLE ACT | a set of standards that are required the the confidentiality of patients records and the processing of health care claims.
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| EXPLANATION OF BENEFITS | a document detailing services billed and descibing payment determinatons.
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| FISCAL INTEREDIARY | an oganization that processes claims for care recived
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| CLEAN CLAIM | a claim submitted on time w/ all the nessary info so that it can be processed and paid promptly
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