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Medical Billing/Code
| Question | Answer |
|---|---|
| How many steps are in the Revenue Cycle? | - 10 |
| What are the first 3 main steps in the Revenue Cycle? | - Preregister Patients, Establish financial responsibility, Check in patients. |
| - AP | - Accounts Payable |
| - AR | - Accounts Receivable |
| - CDHP | - Consumer Driven Health Plan |
| - EHR | - Electronic Health Record |
| - HIT | - Health Information Technology |
| - HMO | - Health Maintenance Organization |
| - MCO | - Managed Care Organization |
| - PMPM | - Per Member Per Month |
| - PMP | - Practice Management Program |
| - PPO | - Preferred Provider Organization |
| - PCP | - Primary care Physician |
| What are the 3 main knowledge requirements MA's should know? | - Knowledge medical insurance, reimbursement options, and EHR systems |
| Who is reliable on handling the CASH FLOW through the financial success | - The revenue Cycle |
| _____ _____ specialist help ensure financial success. | - Medical Insurance Specialist |
| _____ _____ is a written policy stating the terms of an agreement between ________ (a individual) and a ______ ______ (an insurance company). | 1. Medical Insurance 2. Policyholder 3. Health Plan |
| Health plans provide _________ (payments for medical services). | - Benefits |
| Health plans are often referred to as _________. | - payers |
| - Describe this term... (Third-Party Payer) | 1. is a government agency or private organization insuring or paying for healthcare on behalf of beneficiaries |
| Medical coder does four thing? What are they? | Billing, Coding, Reimbursement, and Data Inserts |
| What is CPT? | Current Procedure Terminology |
| What is ICD-10-PCS? | This type of coding is for Inpatient coding |
| CDT? | Current Dental Terminology |
| AAPC? | American Academy of Professional Coders |
| Where can Medical Coders work? | Provider offices, Hospitals, Private companies, Home, Insurance companies, vendors, Law Specters, etc |
| Professional Coding? | is coding for provider specialists - Provider based services. |
| Inpatient Coding? | like coding for inpatient coding such as hospitals |
| Where does the icd-10-cms start? | |
| What is office of inspector general? | has the task of detecting healthcare fraud and abuse for enforcing all laws relating to them |
| What is Fraud? | intentional deceptive act to obtain a benefit: Financial gain. |
| What is abuse? | Action that improperly uses another persons resources |
| Encryption? | A method of scrambling transmitted data so they cannot be deciphered without the use of a confidential process or key. |
| PHI cannot be released without? | authorization for treatment, payment and healthcare operations. |
Created by:
KIMMYCO
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