Important Documents and Notices
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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| A notice that a doctor, supplier, or provider gives a Medicare beneficiary before furnishing an item or service if they believe Medicare may deny payment. | show 🗑
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| The legal obligation of providers to explain use and disclosure of patient's protected health information (PHI). | show 🗑
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| Needs at least 1 witness and need to happen before rendering a service/procedure; it is important that original or scanned copies are part of a patient's health record. | show 🗑
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| Permission granted by the patient or the patient's representative to release information for reasons other than treatment, payment, or health care operations. | show 🗑
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| A patient's permission evident by signature for treatment, payment, or health care operations. | show 🗑
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| show | Remittance Advice (RA)
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| Notification by the physician to a patient that a service will not be paid. | show 🗑
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| show | Referral
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| Describes the services rendered, payment covered, and benefit limits and denials; sent to patient from insurance company. | show 🗑
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| show | Medicare Summary Notice (MSN)
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| show | Authorization
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| A written request for verification of benefits. | show 🗑
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