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Introduction to Medical Billing & Coding Flashcards

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3255408271WHOWorld Health Organization0
3255411188ICDInternational Classification of Diseases1
3255414014Who developed ICD to:collect data for statistical purposes2
3255415365CPTCurrent Procedural Terminiology3
3255423377CPT was developed by...American Medical Association4
3255423378AMAAmerican Medical Association5
3255429244Medicarefederal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease6
3255433723MedicaidA joint federal and state program that helps low-income individuals or families pay for the costs associated with long-term medical and custodial care, provided they qualify.7
3255437579Medicaid is funded by ....funded by the federal government, Medicaid is run by the state where coverage may vary.8
3255439797Medicaid is run by...funded by the federal government, Medicaid is run by the state where coverage may vary.9
3255444216HIPAAHealth Insurance Portability and Accountability Act of 199610
3255448098HIPAA regulatesandates regulations that govern privacy, security, and electronic transaction standards for health care information11
3255453058PIPPersonal Injury Protection12
3255455777PIPReimburses medical expenses for covered individuals, regardless of fault, for treatment due to an auto accident.13
3255461262Disability Insuranceoffers income protection to individuals who become disabled for a long period of time, and as a result can no longer work during that time period14
3255467748Disability insurance is managed bySocial Security15
3255471891Disability insurance is paid ifWas under the care and treatment of a licensed provider during initial disability and continues care with the same16
3255474343OSHAOccupational Safety and Health Administration17
3255476807OSHA protectsprotect all employees against injuries from occupational hazards in the workplace18
3255479650OSHA is an agency underU.S. Department of Labor19
3255490909HMOHealth Maintenance Organization20
3255497776HMO gives access to what doctors and nursesThose within their network, care is covered only if you see a doctor within their network (few opportunities for out of network docs)21
3255503853Networks are made up ofproviders that have agreed to lower their rates for plan members and also meet quality standards22
3255513963Lower insurance premiumsHMO23
3255519923PPOPreferred Provider Organization24
3255528020PPO gives you access to what doctors and nursesThose within and outside of network, but better cost if you see an in-network doc25
3255536651Higher insurance premiumsPPO26
3255541440low or no deductibleHMO27
3255545531HMO Act of 1973authorized federal grants and loans to private organizations that wished to develop HMOs which are responsible for providing health care services to subscribers in a given geographic area28
3255548831Blue Cross Policyplan initiated by Baylor University to guarantee Dallas teachers 21 days of hospital care for $6 a year, in 192929
3255553882DRG stands forDiagnosis Related Group30
3255553883DRG isstatistical system of classifying any inpatient stay into groups for the purposes of payment31
3255560310Copayment is abbreviatedCo-Pay32
3255561837Co-Payin an insurance policy and paid by an insured person each time a medical service is accessed33
3255571646BCBSBlue Cross Blue Shield34
3255571647Clinical Laboratory Improvements ActCLIA35
3255580595CLIAregulates all laboratory testing (except research) performed on humans in the U.S.36
3255586122AMA is formedical organization for professionals and medical students37
3255588297Third Party AdministratorTPA38
3255588298TPAAn organization that administrates group insurance policies for an employer39
3255594366Civilian Health and Medical Program of the Department of Veterans AffairsCHAMPVA40
3255597440CHAMPVAcomprehensive health care program in which the Department of Veterans Affairs (VA) shares the cost of covered health care services and supplies with eligible beneficiaries41
3255605607Who are CHAMPVA beneficiariesThe spouse or child of a veteran who has been rated permanently and totally disabled for a service-connected disability by a VA regional office, or The surviving spouse or child of a veteran who died from a VA-rated service-connected disability, or The surviving spouse or child of a veteran who was at the time death rated permanently and totally disabled, or The surviving spouse or child of a military member who died in the line of duty, not due to misconduct (in most of these cases, these family members are eligible for TRICARE, not CHAMPVA).42
3255617219Tricaremilitary insurance43
3255627451Who is eligible for TricareActive duty family members Retired service members and their families Family members of activated Guard/Reserve members Non-activated Guard/Reserve members and their families who qualify for care under the Transitional Assistance Management Program Retired Guard/Reserve members (age 60 and receiving retired pay) and their families Survivors Medal of Honor recipients and their families Qualified former spouses44

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