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H.I.T

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
        Help!  

Question
Answer
what happens after the claim is submitted?   the third-party payer or health insurer, is reviewing the claim  
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accounts receivable department   department that keeps track of what third party payers the provider is waiting to hear from & what pts are due to make a payment  
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what is the primary purpose of CDM?   to make sure the provider accurately charges the pt for routine services & supplies  
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aging report   measures the outstanding balances in each account  
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how are aging reports maintained?   in 30 day increments  
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why are aging reports useful?   they help the office staff see which accounts have not been paid  
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Remittance Advice   report sent from the 3rd party payers to the provider  
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where is the EOB sent?   sent to the policyholder  
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medicare summary notice (MSN)   document that outlines the amts billed by the provider & what the pt must pay the provider  
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what does is mean when physicians accept assignment?   the health care professional accepts as payment in full Medicare's allowable charge  
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what's another name for posting payments?   reconciliation & collections  
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group codes   identify the party financially responsible for a specific service or the general category of payment adjustment  
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claims adjustment reason codes (CARCs)   provide financial info about claims decisions  
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remittance advice remark codes (RARCs)   further explain reason for a payment adjustment  
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provider-level adjustment reason codes   are not related to a specific claim. These adjustments are made by the provider's office  
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affordable care act(ACA)   is how pts can appeal health ins decisions  
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who benefits from the appeals process?   the pt  
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when can a pt request an external independent review?   if the claim is still denied  
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Created by: diasiar
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