Question | Answer |
what is the purpose of workers compensation | to provide medical care to injured employee, reimburse provided for services rendered to the injured employee, compensate employee with an income while recovering |
what does workers compensation benefits include? | Disability settlements, temporary disability income, rehabilitation and medical treatment |
what is an explanation of benefits? | explains what expenses were paid by the insurance company and sent to the physician's office |
what is workers compensation? | A type of insurance that protects workers from loss of wages |
what is allowable or allowed amount? | Max amount that a third-party payer will pay for services |
what is a provider who has signed a contract with the insurance carrier called? | Participating provider |
what is the money the policyholder pays before the insurance company will start to pay on claims? | The deductible |
how many digits do CPT codes consist of? | 5 digits |
what is the name of health insurance for the spouses and dependence of uniformed military personnel? | TRICARE |
what is paid to keep the insurance policy in force? | The premium |
what should you get when verifying insurance? | name of the contact person |
How are hardcopy claims sent? | US mail |
how are electronic claims sent? | Via the Internet directly to the insurance carrier is called direct billing |
what does CPT mean? | Current Procedural Terminology |
what are claims that have errors or omissions that must be corrected called? | Dirty |
what must the position document on a work comp claim? | Date, how and where the accident happened |
what are the three types of disability claims? | Non disability can return to work after being treated, NO WHERE clause temporary disability and permanent disability |
how should you always start coding? | in the alphabetical index |
should you ever code from the alpha index alone? If not what should you do? | no, you should always verify in the tabular index |
what does AUDIT mean? | to examine claims for accuracy and completeness before they are sent to the insurance carrier |
how is verification of insurance done? | By calling me insurance carrier or by going online to their website |