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Carnegie insurance f
commercial insurance final exam review and MA fall 2014
| Question | Answer |
|---|---|
| what is the purpose of workers compensation | to provide medical care to injured employee, reimburse provided for services rendered to the injured employee, compensate employee with an income while recovering |
| what does workers compensation benefits include? | Disability settlements, temporary disability income, rehabilitation and medical treatment |
| what is an explanation of benefits? | explains what expenses were paid by the insurance company and sent to the physician's office |
| what is workers compensation? | A type of insurance that protects workers from loss of wages |
| what is allowable or allowed amount? | Max amount that a third-party payer will pay for services |
| what is a provider who has signed a contract with the insurance carrier called? | Participating provider |
| what is the money the policyholder pays before the insurance company will start to pay on claims? | The deductible |
| how many digits do CPT codes consist of? | 5 digits |
| what is the name of health insurance for the spouses and dependence of uniformed military personnel? | TRICARE |
| what is paid to keep the insurance policy in force? | The premium |
| what should you get when verifying insurance? | name of the contact person |
| How are hardcopy claims sent? | US mail |
| how are electronic claims sent? | Via the Internet directly to the insurance carrier is called direct billing |
| what does CPT mean? | Current Procedural Terminology |
| what are claims that have errors or omissions that must be corrected called? | Dirty |
| what must the position document on a work comp claim? | Date, how and where the accident happened |
| what are the three types of disability claims? | Non disability can return to work after being treated, NO WHERE clause temporary disability and permanent disability |
| how should you always start coding? | in the alphabetical index |
| should you ever code from the alpha index alone? If not what should you do? | no, you should always verify in the tabular index |
| what does AUDIT mean? | to examine claims for accuracy and completeness before they are sent to the insurance carrier |
| how is verification of insurance done? | By calling me insurance carrier or by going online to their website |
Created by:
ma2b
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