Ukuran huruf
Lembar kerjaInsurance Terms & Billing review
Total soal: 18
Worksheet time: 54mins
The out-of-pocket expenses that must be paid each year before the insurance company begins reimbursing for expenses
Copay
Coinsurance
EOB
Deductible
An entity that pays for medical services, usually an insurance company
SSC
Payer
Subscriber
Guarantor
Healthcare Common Procedure Coding System
CPT
HCPCS
Modifier
Revenue Code
Practice of submitting a claim to a payer within a window of time specified in the contract with the provider
Timely Filing
in-network
predetermination
Ancillary Services
A form signed by the patient when there is a possibility medical necessity guidelines may not be met based on Medicare coverage rules.
Advanced Beneficiary Notice (ABN)
Referral
Precertification
Financial Waiver
The amount a facility lists as the price for patient services
UCR
coinsurance
Charges
Allowed Amount
Charges added to a patient's account after the final bill
Rebill
Deductible
Late Charges
Bill Type
What patient type(s) must have CPT/HCPCS codes?
(a)
Describes when a patient pays out of pocket for health related services
Primary Payer
Guarantor
Self Pay
Tertiary
An adjustment or discount that a hospital writes off due to a written agreement with the insurance company
Allowed Amount
Remittance Advise
COB
Contractual Adjustment
The universal billing form used by hospitals to bill third party payers
UB-04
Form 1500
SSI
Bill
What rule determines which parents insurance is primary on a dependent?
(a)
Analysis of medical treatment to determine if it is necessary and appropriate to meet the basic health needs of the patient
predetermination
Precertification
Medical Necessity
Doctors Orders
Unique 10-digit identification number issued to health care providers in the United States by CMS
NPI
Taxonomy
PTAN
Tax ID
Approval from a patient's primary care physician for treatment by another doctor
Predetermination Letter
Preauthorization
out of network
Referral
Person who is financially responsible for payment
Subscriber
Dependant
Guarantor
Payer
Services that are provided as part of a hospital stay, but do not include Room & Board.
Late Charges
Ancillary Services
Exclusions
UCR
What Bill Type is for a Hospital Inpatient Initial Bill?
(a)
