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P Mylin Study Stack
Additional for Chapter 4 - HI
Question | Answer |
---|---|
does not contract with the insurance plan, and patients who elect to receive care from nonPARs will incur higher out-of-pocket expenses | non-participating provide (nonPAR) |
the insurance plan responsible for paying health insurance claims first | primary insurance |
policyholder whose birth month and day occurs earlier in the calendar year holds the primary policy for dependent children | birthday rule |
what a superbill is called in the hospital | chargemaster |
set of supporting documentation or information associated with a health care claim or patient encounter | claims attachment |
payers deposit funds to the provider's account electronically | electronic funds transfer |
the routing slip, charge slip, encounter form, or superbill from which the insurance claim was generated | source document |
submitted to carrier, but not paid yet | open claims |
all processing, including appeals, has been completed | closed claims |
assigning lower-level codes than documented in the record | downcoding |
collectors may not harrass debtors | Fair Debt Collection Practices Act |