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4020 wk1
abbv&deff.
| Question | Answer |
|---|---|
| ABN | ADVANCED BENEFICIARY NOTICE |
| MMA | MEDICARE PRESCRIPTION IMPROVEMENT MODERNIZATION ACT |
| CMS | CENTERS FOR MEDICARE AND MEDCAID SERVICES |
| SOF | SIGNATURE ON FILE |
| SSI | SOCIAL SECURITY INCOME |
| HCFA | HEALTHCARE FINANICING ADMINISTRATION |
| CMS-1500 | CENTERS FOR MEDICARE AND MEDICAID SERVICES HEALTH INSURANCE CLAIM FORM |
| RBRVS | RESOURCE BASED RELATIVE VALUE SCALE |
| RVU | RELATIVE VALUE UNIT |
| RA | REMITTANCE ADVICE |
| MG | MEDIGAP |
| ERA | ELECTROINCE REMITTANCE ADVICE |
| EOB | EXPLANATION OF BENEFITS |
| CCI | CORRECT CODING INITIATIVE |
| ESRD | END STAGE RENAL DISEASE |
| LCD | LOCAL COVERAGE DECISIONS |
| ADVANCED BENEFICIARY NOTICE | AN AGREESMENT GIVEN TO THE PATIENT TO READ AND SIGN BEFORE RENDERING A SERVICE THAT MAYBE DENIED OR PAID |
| ASSIGNMENT | AN AGREENMENT SIGNED BY THE PATIENT THAT ASSIGNS THE RIGHT TO RECIEVE PAYMENT FOR THE SERVICE FROM THE INSURANCE |
| CORRECT CODING INITIATIVE | FEDERAL LEGISLATION THAT ATTEMPTS TO ELIMINATE UNBUNDING OR OTHER INAPPROPRIATE REPORTING OF PROCEDURE CODES FOR PROFESSIONAL MEDICAL SERVICES RENDERED TO PATIENTS |
| CROSSOVER CLAIM | A CLAIM AUTOMATICALLY SENT ELECTRONICALLY TO THE SECONDARY PAYER WHEN A PERSON HAS BOTH PRIMARY AND SECONDARY INSURANCES |
| HOSPICE | A PUBLIC AGENCY OR PRIVATE ORGANIZATION PRIMARILY ENGAGED IN PROVIDING PAIN RELIEF SYMPTOM MANAGEMENT OR TERMINALLY ILL AND THEIR FAMILIES |
| RESPITE CARE | SHORT TERM INPATIENT STAY FOR TERMAILLY ILL PATIENT TO GIVE TEMPORAY RELIFE |
| MEDICAL NECESSITY | THE PERFORMANCE OF SERVICES AND PROCEDURES THAT IS CONSISTENT WITH DIAGNOSIS |
| MEDICARE PART A | HOSPTIAL COVRAGE NO CHARGE |
| MEDICARE PART B | OUTPATIENT COVERAGE |
| MEDI-MEDI | INDIVIDUAL WHO RECIEVES MEDICAID AND MEDICARE SIMULTANEOULSY REMITTANCE ADVICE:DOCUMENT DETAILING SERVICES BILLED AND DESCRIBING PAYMENT DETERMINATION ISSUED TO PROVIDERS |
| MEDICARE SECONDARY PAYER | PRIMARY INSURANCE PALN OF MEDICARE BENEFICIARY THAT MUST PAY FOR ANY MEDICARE OR SERVICES FIRST BEFORE MEDICARE IS SENT A CLAIM |
| WHISTLEBLOWERS | SUSPECTED ORDEFRAUDING THE FEDRAL GOVERNMENT |
| ESTABLISHED PATIENTS | INDIVIDUAL WHO RECIEVED PROFESSIONAL SERVICES WITHIN THE PAST 3 YEARS FROM THE PHYSICIAN OR ANOTHER PHYSICIAN IN THE SAME GROUP PRACTICE |
| NEW PATIENT | INDIVIDUAL WHO HAS NOT RECIEVED ANY PROFESSIONAL CARE WITHIN THE PAST 3 YEARS FROM A PHYSICIAN OR ANOTHER PHYSICIAN IN THE SAME GROUP PRACTCE |
| REVIEW OF SYSTEMS | INVENTORY OF SYSTEMS RELATED OT THE CHIEF OF COMPLAINT |
| KEY ELEMENTS | HISTORY PHYCISIAN EXAMINATION MEDICAL DECISION MAKING ARE THE INDIVIDUALIZED STEPS IN THE IDENTIFICATION OF THE CORRECT E/M PROCEDURE CODES FOR SERVICES PERFORMED |
| INITIAL VISIT | FIRST VISIT DURING EPISODE OF CARE |
| SUBSEQUENT VISIT | VISITS AFTER THE INITAL OR FIRST VISIT OF AN EPISODE OF CARE |
| MEDICARE | A FEDERAL HEALTH INSURANCE PROGRAM FOR PEOPLE OVER 65 YEARS OF AGE OF CERTAIN DISABLED/BLIND PEOPLE OR RENAL DISEASE REGARDLESS OF INCOME |
Created by:
markitaboyles
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