commercial insurance final exam review and MA fall 2014
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| 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
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| what does workers compensation benefits include? | Disability settlements, temporary disability income, rehabilitation and medical treatment
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| what is an explanation of benefits? | explains what expenses were paid by the insurance company and sent to the physician's office
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| what is workers compensation? | A type of insurance that protects workers from loss of wages
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| what is allowable or allowed amount? | Max amount that a third-party payer will pay for services
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| what is a provider who has signed a contract with the insurance carrier called? | Participating provider
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| what is the money the policyholder pays before the insurance company will start to pay on claims? | The deductible
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| how many digits do CPT codes consist of? | 5 digits
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| what is the name of health insurance for the spouses and dependence of uniformed military personnel? | TRICARE
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| what is paid to keep the insurance policy in force? | The premium
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| what should you get when verifying insurance? | name of the contact person
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| How are hardcopy claims sent? | US mail
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| how are electronic claims sent? | Via the Internet directly to the insurance carrier is called direct billing
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| what does CPT mean? | Current Procedural Terminology
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| what are claims that have errors or omissions that must be corrected called? | Dirty
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| what must the position document on a work comp claim? | Date, how and where the accident happened
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| 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
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| how should you always start coding? | in the alphabetical index
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| should you ever code from the alpha index alone? If not what should you do? | no, you should always verify in the tabular index
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| what does AUDIT mean? | to examine claims for accuracy and completeness before they are sent to the insurance carrier
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| how is verification of insurance done? | By calling me insurance carrier or by going online to their website
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