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MOD 110 Unit 1
| Question | Answer |
|---|---|
| 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
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