Exam
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| show | 1. Medical Terminology
2. Human Biology
3. Critical reading skills
4. excellent communication skills
5. good computer skills
6, math skills
7. application knowledge of medical insurance
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| Needed to help differentiate between technical descriptions of different but similar diagnoses or procedures | show 🗑
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| show | Medical Terminology
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| What are to 2 most important components of effective oral communication? | show 🗑
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| What is considered appropriate nonverbal communication with a patient ? | show 🗑
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| What are some important humaln relation skills? | show 🗑
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| What are some basic computer hardware knowledge? | show 🗑
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| What are some basic computer terms? | show 🗑
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| brain of the computer | show 🗑
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| show | RAM
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| show | ROM
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| show | Database
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| show | referred to as biomedical and clinical databases.
meaning the ability to save, retrieve, and backup files as necessary.
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| show | -ICD-10-CM
-CPT
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| show | used to code diagnoses
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| show | used to code procedures
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| The process of converting verbal and written descriptions of medical conditions and procedure into numeric and/ or alphanumeric codes. | show 🗑
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| show | beacause the livelihood of the physician and staff depend on it
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| Responsibilities of an insurance specialist: | show 🗑
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| Professional or Medical Etiquette | show 🗑
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| show | Breach of Confidentiality
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| show | Never give information over the phone or in persson until you have verified that the party making the request is entitled to the information.
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| show | faxing patient information
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| An intentional deception or misrepresentation that an individual makes, knowing it to be false which could result in some unauthorized benefit | show 🗑
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| Submitting Claims for items or services that are not medically necessary to treat the patient's condition | show 🗑
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| show | Traditional Insurance
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| show | Medicare (Government Sponsored)
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| show | Medicaid (Government Sponsored)
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| show | TRICARE (Government Sponsored)
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| Reimbursement for lost income resulting from temporary or permanent illness or injury. | show 🗑
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| show | -automobile
-business
-homeowner's
-worker's compensation
-malpractice
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| Which Parent's policy is primary in the case of divorced parents with a minor child (both parents have insurance on the child)? | show 🗑
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| show | Deductible
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| The percentage paid by the insurance carrier or that paid by the insured. After the spplication of the deductible to the submitted bills, the insurance policy pays a percentage of the remaining amount. | show 🗑
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| Participating Provider | show 🗑
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| show | Insurance claim form used by Medicare and accepted by nearly all insurance carriers. Formerly known as the HCFA-1500 form
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| Fair Debt Collection Practice Act | show 🗑
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| What information should be obtained when a New Patient arrives? | show 🗑
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| show | All Patients (with insurance)
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| show | the financial record source document used by health care providers
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| show | Diagnosis Code
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| show | CMS-1500 form (formerly HCFA-1500) Developed by CMS-Centers for Meidcare and Medical services
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| show | divided into 33 sections or blocks
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| show | -incorrect coding of diagnosis or procedures
-missing policy numbers
-diagnosis codes and procedure codes do not match
-charges not itemized
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| show | is a statement telling the patient and/or provider how the insurance company determined it's share of the reimbursement.
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| show | 3 seperate provisions that govern phsician self-referral patients.
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| "Stark II" | show 🗑
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