Medical Billing Key Terms
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
---|---|---|---|---|---|
accounting cycle | the flow of financial transactions in a business
🗑
|
||||
accounts receivable | monies that are flowing into a business
🗑
|
||||
adjudication | series of steps that determine whether a claim should be paid
🗑
|
||||
billing cycle | regular schedule of sending statements to patients
🗑
|
||||
capitation | advance payment to a provider that covers each plan member's health care services for a certain period of time
🗑
|
||||
coding | a way of translating a description of a condition into a shorter, standardized code
🗑
|
||||
coinsurance | part of charges that an insured person must pay for health care services after payment of the deductible amount
🗑
|
||||
consumer-driven health plan (CDHP) | a type of managed care in which a high-deductible/low-premium insurance plan is combined with a pretax savings account to cover out-of-pocket medical expenses, up to the deductible limit
🗑
|
||||
copayment | a small fixed fee paid by the patient at the time of an office visit.
🗑
|
||||
diagnosis | physician's opinion of the nature of the patient's illness or injury
🗑
|
||||
diagnosis code | a standardized value that represents a patient's illness, signs, and symptoms.
🗑
|
||||
encounter form | a list of the procedures and charges for a patient's visit.
🗑
|
||||
explanation of benefits (EOB) | paper document from a payer that shows how the amount of a benefit was determined
🗑
|
||||
fee-for-service | health plan that repays the policyholder for covered medical expenses
🗑
|
||||
Health Maintenance Organization (HMO) | a managed health care system in which providers agree to offer health care to the organization's members for fixed periodic payments from the plan
🗑
|
||||
health plan | a plan, program, or organization that provides health benefits
🗑
|
||||
managed care | a type of insurance in which the carrier is responsible for both the financing and the delivery of health care
🗑
|
||||
medical coder | a person who analyzes and codes patient diagnoses, procedures, and symptoms
🗑
|
||||
medical necessity | treatment provided by a physician to a patient for the purpose fo preventing, diagnosing, or treating an illness, injury, or its symptoms in a manner that is appropriate and provided in accordance with generally accepted standards of medical practice.
🗑
|
||||
patient information form | form that includes a patient's personal, employment, and insurance data needed to complete an insurance claim
🗑
|
||||
payer | private or government organization that insures or pays for health care on the behalf of the beneficiaries
🗑
|
||||
policyholder | a person who buys an insurance plan; the insured
🗑
|
||||
practice management program (PMP) | a software program that automates many of the administrative and financial tasks required to run a medical practice
🗑
|
||||
Preferred Provider Organization (PPO) | managed care network of health care providers who agree to perform services for plan members at discounted fees
🗑
|
||||
premium | the periodic amount of money the insured pays to a health plan for insurance coverage
🗑
|
||||
procedure | medical treatment provided by a physician or other health care provider
🗑
|
||||
procedure code | a code that identifies a medical service
🗑
|
||||
remittance advice (RA) | an explanation of benefits transmitted electronically by a payer to a provider
🗑
|
||||
statement | a list of all services performed for a patient, along with the charges for each service.
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
caramel_cutie_no_1
Popular Medical sets