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

Chapter 4

Payment Adjudication

TermDefinition
accounts receivable department department that keeps track of what 3rd party payers provide on what patients are due
explanation of benefits (EOB) describes the services rendered, payments covered benefits and denials
CPT/HCPCS codes must correspond to the description of the service
aging report measures the outstanding balances in each account
charge description master (CDM) Information about health care services that patients have received and financial transactions
Age trial balance (ATB) refers to the status of an invoice aging reports often maintained in 30-day increments
Assessing the Status Accounts aging reports help the staff see which accounts have not been paid by checking the EOB or RA to tell why patient has an outstanding balance
account number number that identifies specific episodes of care for date of service(DOS)
health record number number the provider uses to identify an individual patient's record
Medicare summary notice(MSN) document that outlines the amounts billed by the provider and what the patients pay the provider
Remittance Advice(RA) the report sent from the third party payer to the provider
subscriber purchaser of the insurance or the member of group for which an employer or associations as purchased insurance
subscriber number unique code used to identify a subscriber's policy
cost sharing the balance the policyholder must pay to the provider
batch a group of submitted claims
balance billing billing patients for charges in excess of the Medicare fee schedule
managing denials important to track denials when payments are posted tracked by payer type of denials and provider
affordable care act how patients can appeal health insurance decisions
External Independent if claim is still denied internal appeal patient can request an external independent review
Created by: K.Lindsey
 

 



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