To help understand terminology related to Billing/Coding for MNT
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| advance beneficiary notice | may also be known as waiver of liability. A notice health care provider and supplier are required to give and have signed by an insured to person and insurance care will not cover these services or items
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| authorization | a referral that has been submitted to the patient's insurance company for approval for the services requested to be performed.
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| benefit period | the specified period of time during which charges for covered services must be incurred in order to be eligible for payment by a third party payer/
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| claim | A request for payment for service(s) provided by a health care provider.
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| CMS | Federal agency within the US Dept. of Health and Human Services that administers the Medicare program and Medicaid.
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| Council for Affordable Quality Healthcare | A non-profit alliance of health plans and trade associations which allows industry collaboration to simplified healthcare administration.
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| Current Procedural Terminology | descriptive list of terms and numeric codes used for reporting diagnostic and therapeutic procedures and medical services.
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| Employer Identification Number (EIN) | Used to identify a business entity
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| ICD-10 | WHO uses to report morbidity and mortality information.
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| Medicaid | Federally-funded insurance for low-income adults, their children and people with certain disabilities.
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| Medicare Part A | often called "hospital insurance"
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| Medicare Part B | often insurance for outpatient medical services
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| Medicare Part D | covers prescription drugs.
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| NPI | a universal number assigned to a provider that identifies them as a provider of services to the treatment. Unique, government-issued.
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| Superbill | contains vital information about the professional providing the health care service. A client can submit the bill directly to the health care insurer for payment to the insured.
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