Save
Busy. Please wait.
Log in using Clever
or

show password
Forgot Password?

Don't have an account?  Sign up 
Sign up using Clever
or

Username is available taken
show password

why


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
Your email address is only used to allow you to reset your password. See our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
focusNode
Didn't know it?
click below
 
Knew it?
click below
Don't know
Remaining cards (0)
Know
0:00
share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

CertReview2 3/15

Quiz 2

TermDefinition
authorization Permission granted by the patient or the patients representative to release information for reasons other than treatment, payment, or health care operations
balance billing Billing patients for charges in excess of the Medicare fee schedule
batch A group of submitted claims
Blue Cross and Blue Shield plan The first prepaid plan in the U.S. that offers health insurance to individuals, small businesses, seniors, and large employer groups
business associate (BA) Individuals, groups, or organizations who are not members of a covered entity's workforce that perform functions or activities on behalf of or for a covered entity
capitation the fixed amount a provider receives
case management A review of clinical services being performed
Category I CPT code Code that covers physicians' services and hospital outpatient coding
Category II CPT code Code designed to serve as supplemental tracking codes that can be used for performance measures
Category III CPT code Code used for temporary coding for new technology and services that have not met requirements needed to be added to the main section of the CPT book
charge amount The amount the facility charges for the procedure or service
charge description master (CDM) Information about health care services that patients have received and financial transactions that have taken place
charge or service code Internally assigned number unique to each facility
claim A complete record of services provided by health care professional, along with appropriate insurance information, submitted for reimbursement to a third-party payer
claims adjustment reason code (CARC) Provides financial information about claims decisions
claim scrubber Software that reviews a claim prior to submission for correct and complete data, such as accurate gender in alignment with diagnosis/procedure or medical necessity
clean claim claim that is accurate and complete. They have all the information needed for processing, which is done in a timely fashion
clearinghouse Agency that converts claims into a standardized electronic format, looks for errors, and formats them according to HIPPA and insurance standards
clinical documentation The record of clinical observations and care a patient receives at a health care facility
commercial documentation The record of clinical observations and care a patient receives at a health care facility
Created by: sbogle
 

 



Voices

Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards