Medical office questions and answers
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| The flow of financial transactions in a business is a | show 🗑
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| show | accounts receivable
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| show | billing cycle
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| show | coding
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| show | adjudication
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| show | coinsurance
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| show | capitation
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| show | co-pay
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| list of procedures and charges for a patient's visit | show 🗑
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| show | consumer-driven health plan (CDHP)
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| physician's opinion of the nature of the patient's illness or injury | show 🗑
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| standardized value that represents a patient's illness, signs, and symptoms | show 🗑
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| show | Explanation of Benefits (EOB)
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| a managed health care system in which providers agree to offer health care to the organization's members for fixed periodic payments from the plan | show 🗑
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| type of insurance where the carrier is responsible for both the financing and the delivery of health care | show 🗑
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| show | fee-for-service
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| a plan, program, or organization that provides health benefits | show 🗑
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| treatment provided by a physician to a patient for the purpose fo preventing, diagnosing, or treating an illness, injury, or its symptoms in a manner that is appropriate and provided in accordance with generally accepted standards of medical practice | show 🗑
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| form that includes a patient's personal, employment, and insurance data needed to complete an insurance claim | show 🗑
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| show | medical coder
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| person who buys an insurance plan - the insured | show 🗑
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| managed care network of providers that agree to perform services for plan members at discounted fees | show 🗑
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| show | payer
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| show | practice management program (PMP)
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| show | procedure code
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| show | procedure
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| show | statement
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| show | remittance advice (RA)
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| the periodic amount of money the insured pays to a health plan for insurance coverage | show 🗑
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| show | Protected Health Information
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| What is TPO? | show 🗑
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| show | preauthorization or certification number
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| show | coordination of benefits (COB)
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| show | birthday rule
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| Who gets a walk out receipt or walkout statement? | show 🗑
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| Why would a practice not want to accept a debit or credit? | show 🗑
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| What is PPO? | show 🗑
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| What is HMO? | show 🗑
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| show | health care plans
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| a report that lists errors in a claim | show 🗑
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| What is the information about a patient's past, present, or future physical or mental health or payment for health care that can be used to identify the person? | show 🗑
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| show | clearinghouse
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| What is the use of computers & handheld devices to write & transmit prescriptions to a pharmacy? | show 🗑
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| what is the transfer of a business transaction from one computer to another using communication protocols? | show 🗑
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| national standard identifier for all health care providers, whcih consists of 10 #s | show 🗑
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| show | computer hardware and software system
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| What is the electronic format of the claim used by a physicians office to bill for services? | show 🗑
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| show | HIPPA electronic transaction & code sets standards
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| regulation guidelines that identify the safeguards required to prevent unauthorized access to electronic health care information | show 🗑
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| What is the section of an EOB that identifies who was paid, how much, and when? | show 🗑
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| The deductible under many plans applies to each individual each | show 🗑
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| show | patient
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| show | coverage determination
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| show | nonparticipating provider
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| If a claim is found to not be medically necessary at the level reported, the claim will be | show 🗑
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| If an a claim is downcoded, the medical office assistant should | show 🗑
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| If the appeal is denied, the medical office assistant can complain to the | show 🗑
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| show | appeal
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| Medicare Part B says the main reason for returning an appeal is due to the lack of a | show 🗑
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| show | it didn't happen
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| show | subjective, objective, assesment plan
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| Concerning SOAP, information the patient shares with the doc, is considered to be | show 🗑
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| show | subjective
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| show | peer review
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| Many _____ _____ may see re-billing as a duplicate claim, fraudulent billing, and a notice that payment is delinquent. | show 🗑
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| show | yes
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| An examination and verification of claims submitted by a physician is an | show 🗑
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| How do you make sure you have all info from the insurance card? | show 🗑
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| show | Customer service number #, ID # or policy #, Group #, Co-pay, Co-insurance & Admission certification
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| If an adult has there own policy, plus they are a dependent on another policy, which policy is their primay or secondary? | show 🗑
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| show | Physcian's note
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| What is the encounter form that is preprinted with the ICD-9-CM and CPT codes that are most frequently used in that office? (may be called free ticket or routing slip) | show 🗑
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| show | eligibility
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| show | verfication
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| The #'s or letters that connect an individual to a specific insurance policy is the | show 🗑
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| #'s or letters that connect the patient to an individual policy with a specfic group of other insureds is a | show 🗑
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| A individual that obtains an insurance policy is a ____. (may be called insured) | show 🗑
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| show | primary Insurance policy
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