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Insurance Terms vol1
MOP 110 Ms. Ragadio
|intentional deception or misrepresentation that could result in an unauthorized payment.
|actions inconsistent with accepted, sound medical, business, or fiscal practice.
|scope of practice
|health care services, determined by the state, that an NP and PA can perform.
|Latin for "let the master answer"; legal doctrine holding that the employer is liable for the actions and omissions of employees performed and committed within the scope of their employment.
|statute of limitations
|a statute prescribing a period of limitation for the bringing of certain kinds of legal action.
|an order of the court that requires a witness to appear at a particular time and place to testify.
|CPT code that includes a complete description of the procedure or service.
|medical malpractice insurance
|a type of liability insurance that covers physicians and other health care professionals for liability claims arising from patient treatment.
|involves linking every procedure or service code reported on an insurance claim to a condition code that justifies the need to perform that procedure or service.
|electronic or paper-based report of payment sent by the payer to the provider.
|also called coinsurance payment; the percentage the patient pays for covered services after the deductible has been met and the copayment has been paid.