Medical Billing and Coding
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| Crime | An act that violates criminal law is called
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| Narcotic | What license must a physician have to dispense, prescribe, or administer controlled substances?
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| Non compos mentis | A Latin term signifying that a person is not of sound mind is
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| Breach of duty | Violation or omission of a legal or moral duty is called
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| Unethical | It is ________to deny treatment to an HIV infected patient.
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| Felony | A major crime for which greater punishment is imposed other than a misdemeanor is a
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| Incompetence | Lack of physical or mental fitness is known as
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| Coordination of Benefits | To prevent the insured from receiving a duplicate payment for losses under more than one insurance policy is called
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| Non-verbal communication | Body language, body posture, space and distance are all examples of
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| Outpatient | A patient receiving ambulatory care at a hospital or other health facility without being admitted as a bed patient is called an
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| Negligence | Failure to do something that a reasonable person would do under ordinary circumstances that ends up causing harm to another person or a person's property is
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| at the left hand margin | A business letter written in full block style will have all lines
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| Fax machine | What office instrument is designed to receive and send printed documents via the telephone?
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| Catastrophic | Health insurance that provides protection against the high cost of treating severe or lengthy illnesses or disabilities is called
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| Bioethics | The branch of study of moral issues, questions, and problems, arising in the practice of medicine and in biomedical research is called
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| Partial Disability | An injury that prevents a worker from performing one or more of the regular functions of his job would be known as a
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| Abandonment | The withdrawal of a physician from the care of a patient without reasonable notice of such discharge from a case by the patient is
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| Ethics | what are right and wrong
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| Res judicata | Latin for "things decided" that is, a matter already decided by judicial authority is called
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| Medicare | A health program for people age 65 and older under Social Security is called
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| False Imprisonment | Holding or detaining a person against his or her will is called
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| Health Maintenance Organization (HMO) | An organization that offers health insurance at a fixed monthly premium with little or no deductible and works through a primary care provider is called a
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| First | Business or handwritten mail that weighs less than 11 ounces is known as _______ class mail.
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| Deductible | An amount the insured must pay before a policy begins is called a
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| Claim | A request for payment under an insurance contractor bond is called a
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| Health Insurance Portability and Accountability Act (HIPAA) | is a federal regulation that requires health care professionals to protect the privacy and confidentially of patients health information.
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| Emancipated minor | A person who is no longer under the care, custody, or supervision of a parent is called an
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| Coding | The process of changing words into numbers so that computers can be used in processing insurance claims is called
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| Tri-Care | A civilian health and medical program of the uniform services is called
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| American Medical Association (AMA) Code of Ethics | The statement "A physician shall respect the law" is a part of the
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| Database Management System | A system whereby large quantities of data can be accessed, searched, sorted, and arranged very rapidly by computer is called a
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| Assault | An unlawful threat or attempt to do bodily injury to another is
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| Accident | An unexpected event which may cause injury is called
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| Breach of Contact | Failure to achieve an agreed upon result, even when the highest degree of skill has been used, is called
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| W-4 | The number of Employees Withholding Exemption Certificate is
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| Hardware | A computer monitor, hard drive, and printer are known as
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| Subscriber/policyholder | One who belongs to a group insurance plan is called
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| Delete | The computer key DEL command means
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| Time Limit | A notice of insurance claim or proof of loss must be filed within a designated ____________ or it can be denied.
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| Assignment of Benefits | An agreement by which a patient assigns to another party the right to receive payment from a third party for the service the patient has received is called
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| Worker's Compensation | A form of insurance paid by the employer providing cash benefits to workers injured or disabled in the course of employment is called
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| Usual, Customary and Reasonable | Insurance plans that pay a physician's full charge if it does not exceed his normal charge or does not exceed the amount normally charged for the service is called
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| Speak loudly | When caring for patients with physical disabilities, which of these is not an appropriate consideration for most?
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| Invasion of privacy | A violation of a person's right not to have his or her name, photograph, or private affairs exposed of made public without giving consent is
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| Colon | When caring for patients with physical disabilities, which of these is not an appropriate consideration for most?
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| Res gestae | Latin for "things done;deeds", the facts and circumstances attendant to the act of question would be called
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| October 1 - September 1 | The Tri-Care fiscal year is from
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| Reasonable Care | The health worker is protected by law if it can be determined that he or she acted reasonable as compared with fellow workers. This is called
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| Law | A rule of conduct made by a government body is
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| Medical etiquette | Conduct, courtesy, and manners that are customarily used in a medical office by medical professionals are known as
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| Breach of Confidentiality | Which of these generally results from an act of carelessness, without an intent to harm?
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| Medical Grievance Committee | An impartial panel established to listen to and investigate patient's complaints about medical care or excessive fees is called a
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| Third | An incoming call should be answered by the _______ ring.
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| Provider | A person or institution that gives medical care is a
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| Res Ipsa Loquitur | The presumption or inference of negligence when an accident is otherwise unable to be explained in terms of ordinary and known experience is called
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| Thirds faced-up | A letter should be folded in ___________ using a #10 envelope.
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| Hospital benefits | Payment for hospital charges incurred by an insured person because of injury or illness is called
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| Fourth | Parcel post or ___________ class mail is used for bound printed matter, film, and sound recordings.
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| Extended Care Facility | A skilled nursing facility for patients receiving specialized care after discharge from a hospital is called
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| Forgery | A fraudulent signature is called
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| Gunshot wound | A physician must have the patient's permission in writing to reveal any confidential information except for which of the following?
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| Deposition | Testimony of a witness under oath and written down before trail for possible use when the case comes to trail is
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| Insurance agent | An agent of an insurance company who solicits or initiates contracts for insurance coverage and services, and is the policyholder for the insurer is called
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| Suspension | To interrupt or discontinue a suit temporary with the intention or resumption at a later date, or ask for a continuance is called a
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| Indemnities | Benefits that are made in the form of cash payments are known as
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| Take all complaints seriously | When handling a patient complaint which one of the following would be most appropriate?
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| Adjuster | A person who represents either party of an insurance claim is the
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| Caller's driver license number | Which one of the following items is not needed when taking a routine phone message?
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| Premium | Payment made periodically to keep an insurance policy in force is called a
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| Fee-of-Service | A method of charging whereby a physician presents a bill for each service rendered is called
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| Negligence | The most common type of medical tort liability is
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| Subpoena | A writ that commands a witness to appear at a trail or other proceeding and to give testimony is a
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| Contributory negligence | A patient's failure to act prudently and reasonably, or doing that which a reasonable person would not do under similar circumstances is called
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| Ask the caller if you may put the caller on hold | Before placing a telephone caller on hold it is appropriate to
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| Grammar | is the study of words and their relationship to other words in a sentence.
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| Comprehensive | In insurance, greater coverage of diseases or an accident, and greater indemnity payment in comparison with a limited clause is called
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| Dread disease rider | A rider added to a policy to provide additional benefits for certain conditions is called
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| Move the cursor, right, left, up and down | The computer's directional arrow keys
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| Peer review | Medical research is often published in medical journals that are evaluated by members of the medical community through a process known as
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| Software | The term for the technology that tells a computer what to do is known as the
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| How easy the system is to the user | Referring to computers, the term "user friendly" refers to
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| Privileged Communication | Information given by a patient to medical personnel which cannot be disclosed without consent of the person who gave it is
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| Defamation | Injuring the name and reputation of another person by making false statements to a third person is
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| Third | A newsletter that weighs less than one pound would be considered __________ class mail.
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| Ethics | Right or wrong conduct is known as
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| Empathy | The ability to see things from another person's point of view is
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| Respondeat superior (let the master answer) | Responsibility of an employer for the acts of an employee is
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| Civil law | A statue that enforces private right and liabilities, as differentiated from criminal law is called a
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| Backup | Making a duplicate file to protect computer information from being lost is called making a
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| Judgement | The final decision of a court in an action or suit is
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| Benefits | A sum of money provided in an insurance policy, payable for covered services is called
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| Explanation of benefits | A recap sheet that accompanies a Medicare or Medicaid check, showing breakdown and explanation of payment on a claim is called
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| Consent | Permission granted by a person voluntarily and his right mind is
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| Co-payment | A type of insurance whereby the insured pays a specific amount per unit of service and the insurer pays the rest of the cost is called
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| Grace period | An interval after a payment is due to the insurance company in which the policy holder may make payments, and still the policy remains in effect is called
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| Plaintiff | One who institutes a lawsuit is
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| Will | A legal statement of how an individual's property is to be distributed after death is
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| Participating Physician | A doctor who agrees to accept an insurance companies pre-established fee as the maximum amount to be collected is called
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| Show respect to their culture | When working with patients from a culture different than your own, one should
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| Defendant | A person being sued is called the
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| Fraud | An intentional perversion of truth for the purpose of inducing another in reliance upon it to part with some valuable thing belonging to him or to surrender a legal right is called
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| Assumption of risk | Consent to treatment based on full understanding of all possible risks of unpreventable results of that treatment is called
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| Coinsurance | When a patient has health insurance; the percentage of covered services that is the responsibility of the patient to pay is known as
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| Expert testimony | A statement given concerning some scientific, technical, or professional matter by an expert, such as a physician is called
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| Admission | Under the Peer Review Improvement Act of 1982, Peer Review Organizations are responsible for the review for appropriateness and necessity of putting a patient into the hospital by a process known as ___________ review.
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| Battery | A deliberate physical attack upon a person is called
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| Proximate cause | That which in natural and continuous sequence, unbroken by any new independent cause, produces an event and without which the injury would not have occurred is called
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| Breach | The breaking of a law, promise, or duty is called
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| Smile | Prior to answering an incoming call the medical assistant should
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| Preexisting Condition | A previous injury, disease or physical condition that existed before the health insurance policy was issued is called
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| Health Insurance Portability and Accountability Act (HIPAA) | In the health care field the acronym HIPAA stands for
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| Statue of Limitations | The time established for filing law suits is
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| Tort | A wrong committed against another person or the person's property is a
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| Contract | An agreement between two or more parties for the doing or not doing of some definite thing is
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| Invasion of privacy | Unauthorized disclosure of information regarding any patient to a third party may result in
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| Major Medical | Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called
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| Medigap | Policies that supplement Medicare. Can not have if patient has Medicare Part C
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| Government Employees | Who is covered under federal Blue Cross Blue Sheild?
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| Auto-mobile insurance | What is no-fault?
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| Contract between individual and insurance company individual pays premium and insurance agrees to compensate for loss | What is an automobile insurance policy?
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| Unions usually pay most of premium of insurance | Who is covered under group health insurance?
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| Group and individual | Two types of commercial insurance
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| Medicare, Medicaid, and Tricare | What are three government health plans?
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| Active Military and their dependents | Who is covered under Tricare?
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| Medicare | Which insurance covers individuals 65 & older, Disabled, End Stage Renal Disease (ESRD), and Lou Gehrig's (ALS)?
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| Medicaid | Which insurance covers low income, disabled patients, and their dependents?
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| Blue Cross Blue Shield | Which insurance covers hospitalization?
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| Advanced Beneficiary Notice | form patient signs that will require them to pay for services not covered by Medicare
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| Part A-Hospital Part B-Outpatient Physicians Part C-Medicare Advantage Plans Part D-Prescriptions | What are the four parts of Medicare?
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| Medicare Advantage Plan | Combination of Part A &B under commercial insurance that follows Medicare guidelines
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| Medicare Benefit Period | Begins 1st day of hospitalization
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| Hospice | care provided to terminally ill patients
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| Defensive Enrollment Eligibility Reporting System (DEERS) | Database of military for military personnel and their dependents for healthcare.
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| CHAMPVA | coverage for veterans and their dependents who have been disabled in the line of duty
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| Dual Eligible (Medi/Medi) | Medicare as primary and Medicaid as secondary insurance
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| Medicaid | is jointly funded by federal and state government but each state administers its own Medicaid program
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