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Health allied

Billing

QuestionAnswer
If the insurance plan has a hold harmless clause, it means that the patient is not responsible for paying what the insurance plan denies.
The process of reporting __________ as numeric and alphanumeric characters on the insurance claim is called coding. diagnoses and procedures/services
A claims examiner employed by a third-party payer reviews health-related claims to determine whether the charges are reasonable, in addition to determining medical necessity of services/procedures
Which is another name for a health insurance specialist? reimbursement specialist
claims examiner is employed by a third-party payer to review claims
Which involves linking every procedure or service code reported on the claim to a condition code that justifies the necessity of performing that procedure or service? medical necessity
The CPT manual is published by the American Medical Association
Which is submitted to the payer requesting reimbursement? health insurance claim
The Centers for Medicare and Medicaid Services (CMS) agency is located in the DHHS
When a health insurance plan’s preauthorization requirements are not met by providers payment of the claim is denied
Which coding system is used to report procedures and services on claims? CPT
Which would be found on a remittance advice? payment information about a claim
Which guarantees repayment for financial losses resulting from an employee’s act or failure to act? bonding insurance
Medical malpractice insurance is which type of insurance? liability
Which type of insurance covers employees and their dependents against injury and death that occurs during the course of employment? workers’ compensation
The word embezzle means to steal
Independent contractors should purchase __________ liability insurance, which provides protection from claims that contain errors and omissions resulting from professional services provided to clients as expected of a person in the contractor’s profession professional
Which term describes the principles of right or good conduct and includes rules that govern the conduct of members of a profession? ethics
The Healthcare Common Procedure Coding System (HCPCS) consists of __________ codes CPT and national
Health information technicians manage medical records
The organization that hires a(n) __________ is not liable for the acts or omissions of that individual independent contractor
During completion of a student internship, the facility will likely require students to sign a nondisclosure agreement to protect patient confidentiality
Which coding system is used to report procedures and services on inpatient hospital claims? ICD-10-PCS
.Which does a provider usually employ to perform administrative and clinical tasks, which help keep the office or clinic running smoothly? medical assistant
Which are published by CMS and used to report procedures, services, and supplies not classified in CPT? national codes
Which is Latin for “let the master answer,” which means that the employer is liable for the actions and omissions of employees as performed and committed within the scope of their employment? respondeat superior
Which defines a profession, delineates qualifications and responsibilities, and clarifies supervision requirements? scope of practice
Created by: anastephens