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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 |
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pmylin
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