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MOD 110 Unit 1

Accounts Receivable Management Organization and administration of coding and billing in a medical practice
Assignment A transfer, after an event insured against, or an individual's legal right to collect an amount payable under an insurance contract
Capitation A system of payment used by managed care plans in which physicians and hospitals are paid a fixed per capita requesting payment for service
Claims A bill sent to an insurance carrier requesting payment for services rendered; also known as encounter record
CMS Center for Medicare and Medicaid services
COBRA Consolidated Omnibus Budget Reconciliation Act
Coinsurance A cost-sharing requirement under a health insurance policy providing that the insured will assume a percentage of the costs for covered services
Conditionally Renewable An insurance policy renewal provision that grants the insurer a limited right to refuse to renew a health insurance policy at the end of a premium payment period
Coordination of Benefits (COB) Two insurance carruies working together and coordinating the payment of thier benefits so that there is no duplication of benefits [paid between the primary and 2nd insurance carriers
Deductible A specific dollar amount that must be paid by the insured before a medical insurance plan or government program begins covering health care costs
Encounter Form An all-encompassing billing form personalized to the practice of the physician, it may be used when a patient submits an insurance billing
EOB Explanation Of Benefits
Exclusive Provider Organziation (EPO) A type of managed health care plan that combines features of HMOs and PPO
Foundation for Medical Care (FMC) An organization of physicians sponsored by a state or local medical association concerned with development and delivery of medical services and the cost of health care
Guarantor An individual who promises to pay the medical bill by signing a form agreeing to pay or who accepts treatment, which constitutes an expressed promise
Health Insurance A contract between the policyholder or member insurance carrier or government program to reimburse
HIPAA Health Insurance Portability and Accountability Act
Indemnity Benefits paid to an insured while disabled
Medicaid (MCD) A ferderally adied, state operated, and state-administered program that provides medical benefits for certain low-income persons in need of health and medical care
Medicare (M) A nationwide health insurance program for persons age 65 years of age and older and certin disabled or blind persons regardless of income,
Point-of-service (POS)Plan A managed care plan in which memebers are given a choice as to how to receive services, whether through an HMO, PPO, or fee-for-service plan
PPO Perferred Provider Organization
Preauthorization A requirement of some health insurance plans to obtain permission for service procedure before it is done and to see whether the insurance program agrees it is medically necessary
Premium The cost of insurance coverage paid annually, semiannually, or monthly to keep the policy in force
Bi/o Life
Chem./o Chemical
Onc/o Tumor
Macr/o Large
Eti/o Cause
Therm/o Hot,heat
Radi/o Ray,x-ray
Pyr/o Heat,fire
Prefix To fix before or to fix top the beginning of a word
Suffix To fasten on, beneath, or under
Word Root A word element from which other words are formed
Combining Form A word root to which a vowel has been added
ab Away from
Acute Sudden,sharp,severe: a disease that has a sudden onset, severe symptoms, and a short course
anti Against
dia Through
-al Pertaining to
-pathy Disease
-graphy Recording
hypo Below,under,deficient
-ic Pertaining to
Bx Biopsy
ENT Ear,Nose,Throat
Dx Diagnosis
GYN Gynecology
Created by: Stine25