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| 10749840378 | Three parties of an insurance contract | 1. Patient/ subscriber 2. Provider/ PCP 3. Payer/ insurance | 0 | |
| 10749840379 | fee for service | Payment method based on provider charges | 1 | |
| 10749840380 | Capitated rate | Prospective payment - fixed prepayment covering provider's services for a plan member for a specified period | 2 | |
| 10749840381 | Out of pocket expenses | Expenses the insured must pay out of pocket prior to benefits | 3 | |
| 10749840382 | Referral | Transfer of patient care from one physician to another | 4 | |
| 10749840383 | Pre- authorization | Prior authorization from a payer for services to be provided | 5 | |
| 10749840384 | Medicare | Over 65 years, people with specific disabilities | 6 | |
| 10749840385 | Medicare Part A | Hospital coverage | 7 | |
| 10749840386 | Medicare Part B | Outpatient care - medigap | 8 | |
| 10749840387 | Medicare part C | HMO - combines coverage for part A and part B | 9 | |
| 10749840388 | Medicare Part D | Prescription drug coverage | 10 | |
| 10749840389 | Tricare | military insurance | 11 | |
| 10749840390 | CHAMPVA | veterans insurance | 12 | |
| 10749840391 | Medicaid | Low income people who cannot afford medical care | 13 | |
| 10749840392 | EMR | Computerized records of one physicians encounters with a patient over time that are the physicians legal record of patient care | 14 | |
| 10749840393 | EMR | electronic medical record | 15 | |
| 10749840394 | Subpoena Duces Tecum | Court requires the witness to bring evidence | 16 | |
| 10749840395 | CMS | Centers for Medicare and Medicaid Services | 17 | |
| 10749840396 | HIPAA Security Rule | law requiring covered entities to establish physical and technical safeguards to protect health information | 18 | |
| 10749840397 | HIPAA rules | Privacy, security, electronic code set standards | 19 | |
| 10749840398 | HIPAA Privacy Rule | Law regulating the use and disclosure of patients protected health information as TPO and PHI | 20 | |
| 10749840399 | Electronic code set standards | Require every provider who does business electronically to use the same healthcare transactions, code sets and identifiers | 21 | |
| 10749840400 | PHI | Protected Health Information | 22 | |
| 10749840401 | Three covered entities | 1. Providers 2. Payers/ insurance 3. Business associates and billing clearinghouse | 23 | |
| 10749840402 | NPI | National Provider Identifier | 24 | |
| 10749840403 | NPI definition | Unique ten digit identified assigned to each provider | 25 | |
| 10749840404 | CMS | Agency that runs Medicare, Medicaid, clinical laboratories, and other government health programs | 26 | |
| 10749840405 | Assignment of benefits | Authorization allowing benefits to be paid directly to a provider | 27 | |
| 10749840406 | Premium | Money the insured pays to a health plan for a policy | 28 | |
| 10749840407 | Deductible | Amount insured must pay for healthcare services before a health plan's payment begins | 29 | |
| 10749840408 | Coinsurance | Portion of charges an insured person must pay die covered healthcare services after the deductible | 30 | |
| 10749840409 | Copayment | Specified amount a beneficiary must pay at the time of a healthcare encounter | 31 | |
| 10749840410 | PCP | Primary care physician | 32 | |
| 10749840411 | PPO | preferred provider organization | 33 | |
| 10749840412 | Birthday rule | Guideline stating that the parent whose day of birth is earlier in the calendar year is primary | 34 | |
| 10749840413 | coordination of benefits | Explains how an insurance policy will pay if more than one policy applies | 35 | |
| 10749840414 | Self pay patient | Patient with no insurance | 36 | |
| 10749840415 | Sequelae | Conditions that remain after an acute illness or injury has been treated and resolved | 37 | |
| 10749840416 | Z code | Used to report encounters for circumstances other than a disease or injury | 38 | |
| 10749840417 | ICD-10 | Mandated code set for diagnoses under HIPAA | 39 | |
| 10749840418 | Eponym | Name of phrase formed from or based on a persons name. Ex: Hodgkin's disease | 40 | |
| 10749840419 | HIPAA | Health Insurance Portability and Accountability Act | 41 | |
| 10749840420 | External cause code | ICD-10-CM code for an external cause of a disease or injury | 42 | |
| 10749840421 | HMO | health maintenance organization | 43 | |
| 10749840422 | HMO Definition | Managed healthcare system in which providers offer healthcare to members for fixed periodic payments | 44 | |
| 10749840423 | Schedule of benefits | List of medical expenses covered by a health plan | 45 | |
| 10749840424 | CPT | Current Procedural Terminology | 46 | |
| 10749840425 | Preferred provider organization | Managed care organization in which a network of providers supplies discounted treatment for plan members. Most popular health insurance | 47 | |
| 10749840426 | Protected Health Information (PHI) | Individually identifiable health information that is transmitted or maintained by electronic media. | 48 | |
| 10749840427 | PCP | Physician in health maintenance organization who directs all aspects of a patients care | 49 | |
| 10749840428 | Advanced beneficiary notice (ABN) | Form given to medicare beneficiaries indicating the charges patients need to pay | 50 | |
| 10749840429 | Preventive medical services | Care provider to keep patients healthy or prevent illness | 51 | |
| 10749840430 | NPP | Notice of Privacy Practices | 52 | |
| 10749840431 | NPP DEFINITION | Notice of privacy that explains HIPAA | 53 | |
| 10749840432 | Usual fee | normal fee charged by a provider | 54 |
