Term
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Definition
| protects wage earner from creditors |
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Term
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Definition
| Reorganization of a business |
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Term
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Definition
| assets are liquidated & distributed |
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Term
| Ancillary Diagnostic Service |
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Definition
| services that support patient diagnosis |
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Term
| Ancillary Therapeutic Services |
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Definition
| services that support patient treatment |
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Term
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Definition
| pre-existing conditions that will cause an increased length of hospital stay |
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Term
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Definition
| amount paid to purchase a policy |
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Term
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Definition
| amount that must be paid prior to coverage |
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Term
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Definition
| amount paid at the time of service |
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Term
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Definition
| provision to prevent duplication of payment |
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Term
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Definition
| authorizing payment directly to physician |
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Term
| Should the MA know what is covered under managed care? |
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Definition
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Term
What is the date format you use when filling out a
CMS-1500 claim form?
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Definition
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Term
| Should you send a supplemental medical report to workers comp after each visit? |
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Definition
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Term
| Is providing good patient education telling them about office collection policies and procedures in written form? |
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Definition
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Term
| Is the patient still responsible for part of the bill for an office visit after the insurance has paid? |
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Definition
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Term
| Should you copy both sides of the patients insurance card? |
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Definition
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Term
| Is precertification required before a procedure is done? |
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Definition
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Term
| Is the waiting period for medical and hospital care for those injured on the job three days? |
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Definition
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Term
| CHAMPVA is a federal program that covers dependents of active duty military personnel. |
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Definition
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Term
| A patient is covered by Medi-Medi has both Medicare and Medicaid. |
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Definition
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Term
| Will Medicaid pay for Medicare part B premiums and deductibles for people that qualify? |
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Definition
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Term
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Definition
| explanation of benefits, shows what the insurance has paid |
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Term
| What is the birthday rule? |
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Definition
| Used to determine which insurance will be billed first, ther person whose birthday is first in the year is the primary insurance |
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Term
| If a patient is not approved for a particular service what should the physician do? |
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Definition
| write a letter to the MCO |
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Term
| What guidelines should be followed when making an appointment? |
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Definition
Understand what insurance they have
see if the physician participates
let patient know of any fees |
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Term
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Definition
| patient is given a written document that must be presented to a specialist |
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Term
| Does a patient need to choose a PCP when they are part of an HMO? |
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Definition
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Term
| What is a common mistake when coding for an insurance claim? |
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Definition
| Missing 4th or 5th digit of the ICD9 |
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Term
| What is the correct way to enter charge amounts on a claim form? |
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Definition
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Term
| When is an account considered to be delinquent? |
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Definition
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Term
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Definition
| used to explain circumstances that alter a service when submitting a claim for services |
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Term
| What level of history would include an extensive history, ROS, and document pertinent past, family and social history? |
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Definition
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Term
| What would be the best way to describe accounts receivable? |
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Definition
| unpaid balances due from patients for services rendered |
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Term
| Procedure of arranging accounts receivable by age from the date of service is what? |
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Definition
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Term
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Definition
| a consumer protection act that applies to anyone that charges interest or agrees on payment of a bill in more than 4 installments |
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Term
| What would intentional misrepresentaion of facts be? |
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Definition
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Term
| What is the form called that is sent by a physician after treating a patient for a work related injury? |
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Definition
| first treatment medical report |
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Term
| What method is used for payment of a blue plan claim? |
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Definition
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Term
| Which type of Tricare plan is similar to an HMO? |
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Definition
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Term
| What is the purpose of workers comp? |
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Definition
| to provide the best medical care to ensure prompt return to work |
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Term
| What method is reimbursment determination does the carrier agree to pay a percentage of a fee and the facility must write off the rest? |
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Definition
| Usual, customary, reasonable fee |
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Term
| Which part of Medicare covers people over 65 and provides inpatient hospital care? |
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Definition
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Term
| What type of a plan does a physician contract to agree on a predetermined list of charges for services? |
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Definition
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Term
| What describes capitation? |
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Definition
| set amount paid to the physician per patient in advance |
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Term
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Definition
| provides coverage to a business or homeowner |
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Term
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Definition
| facility that receives claims and distributes to various insurance carriers after checking for errors |
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Term
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Definition
| individual entitled to receive benefits from an insurance policy |
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Term
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Definition
| provides greater benefits and have lower premiums |
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Term
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Definition
| a form that is a charge slip, statement, and insurance reporting form |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| plastic repair of oviduct |
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Term
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Definition
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Term
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Definition
| any disease specific to women |
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Term
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Definition
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Term
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Definition
| period of development in the uterus |
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Term
| A zygote forms as a result of what? |
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Definition
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Term
| What is the function of the amniotic sac? |
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Definition
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Term
| HCG, the hormone produced early in pregnancy that maintains the corpus luteum? |
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Definition
| Human Chorionic gonadtropin |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| tubal ligation is performed for the purpose of what? |
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Definition
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Term
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Definition
| area involved in an episiotomy |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| lower narrow portion of the uterus |
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Term
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Definition
| regular monthly menstrual cycles cease |
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Term
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Definition
| external female genital organs together |
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Term
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Definition
| anatomic equivalent to penis |
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Term
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Definition
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Term
| Where is a laparoscope introduced into the body? |
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Definition
| Through the abdominal wall |
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Term
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Definition
| release of an ovum from the ovary |
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