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!
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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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