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103 unit 2

Medical

QuestionAnswer
Bundling one CPT is used to group more than one component (procedure)
Medicare part A hospuital benefits of a nationwide health insurance for 65 years and older
Benign not cancer
malignant cancerous, can metastasize(grow)can be lifwe threatening
Work Compensation insurance Insurance available for on the job injuries
Medicare insurance offered to all people over the age of 65 years of age
Capitation reimbursement to a healcare provider as a fixed amount per number in a given time period
Clean claim insurance claim from with no mistakes
Fiscal agent an insurer which is under contract to administer an insurance program (process and pay claims)
Gatekeeper Primary physcian or health care profesional assigned by the insurer to review the medical managment tp plan enrolles
Network a health care profesional who has contracted with an insurance plan the patient has
Out of network A health care profeional who has not contraced with an insurance plan the patient has
Participating Provider a physcian who accepts assignments under insurance contract
Provider A physcian, supplier or provider of medical care
Subscriber person named as principal in an insurance contract
Dependents family members of the insured who are covered under the insurance plan
Effective date the date the coverage starts
Lapse termination of a coverage sue to failure to pay
Mandated rquired by law
New patient a person who has never been een by the provider
Created by: rebeccabear