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Bus. Final Review

Final Review BUs. Practices, Chapters 13-18

QuestionAnswer
FCRA Fair Credit Reporting Act
2 types of bankruptcy Chapter 7 & 13
Individual Responsibility Program (IPR) Concierge Medicine/Retainer
Check 21 21st Century- paper to electronic
Endorsements Blank (just signature), Restrictive (for deposit only), Special or Full (pay to the order of)
Accounting Systems single, double, Peg, computerized
Single done by hand, accepted in both federal and states
Double books must balance, requires person w/ advanced accounting skills
Peg Board most popular and oldest (daysheet, deposit, etc..)
Computerized quickest, expensive, least amt of errors
A/R Accounts receivable- money coming in such as claims, co-pays, ins. payments
A/P Accounts Payable- monies going out; are liabilities
Assets anything owned by the business
Capitol original investement
Proprietorship owner's net worth
liability accounts payable, must pay out- BILLS
credit to trust
CPT Current Procedural Terminology
CPT has how many sections? how many numbers in a codes? how many numbers in a modifier? 6; 5;2
Cpt codes 99 Evaluation & Management
CPT codes 90 Medicine
CPT codes 80 Path & Lab
CPT codes 70 Radiology
CPT codes 60-10 Surgery
CPT codes 00 Anesthesia
E/M codes TOS, POS, Pt Status- occifece
Medicine non-invasive medical procedures, inj. vaccines
Path&Lab cultures, microbiology
ICD International Classification of a Disease
HMO oldest, capitation yearly, no out of network, broekn into staff, group network
PPG IPA/HMO Ambulatory; PPO hospital
POS HMO & PPO
IPA an HMO but monthly capitation
Medicare 65 and older, blind, disabled, RBRVS
Medicaid poor, blind disabled, always secondary insurance
Types of referrals formal, direct, verbal, self
exclusions specific conditions that ins. policy will not pay
waivers if ins. doesn't pay, you can claim/ask for coverage
Pre Certification procedures
Pre Authorization medical necessity
HDHP high deductible health plan
Cafeteria Insurance let's us put money aside for own healthcare HSA;FSA
CoPay pay at time of visit
Deductible must pay before insurance will pay
Premium pay periodically to keep a plan
EOB Explanation of benefits
ICD-10 codes 3-7 digit code Alpha Numerical
Tricare Standard, Extra & Prime
CHAMPVA Veterans, honorable discharge
COBRA when you lose your insurance
Unit values for each procedure codes; for filing claims for all EXCEPT Medicare RVS
RBRVS JUST MEDICARE/All Fees for Medicare
Layman term EOB, called RA for Medicare. RA sent to Pt's, ___________ sent to PT MSN, because it is from MEDICARE
terms in a group insurance policy that allowed the insured to continue same or lesser coverage under an individual policy conversion priviledge
Advanced Beneficiary Notice medicare doesn't deem a service or supply necessary
FDCPA Fair Debt Collection Practice Act
2 digit modifier in CPT enhances, backs up or changes the original code
ICD-10- 3- category, etiology, location, duration; Volume I & II Index is V2; descriptions V1
HCPCS I & II DME; DME POS; temporary or permanent
HSA; FSA only for health; use w/ other things but you get a charge
giving funds payer, maker, drawer
receiving funds payee bearer
financial institution drawee
Created by: Gmtassa23