Terms : Hide Images
| 3627341544 | Health Insurance Claim | is the documentation submitted to a third-party payer or government program requesting reimbursement for health care services provided. | 0 | |
| 3627349358 | Medical Assistant | is employed by a provider to perform administrative and clinical tasks that keep the office or clinic running smoothly. | 1 | |
| 3627355136 | Remittance Advice | which is a notice sent by the insurance company that contains payment information about a claim. | 2 | |
| 3627359148 | Professional Liability Insurance | which provides protection from claims that contain errors and omissions resulting from professional services provided to clients as expected of a person in the contractor's profession. | 3 | |
| 3627363567 | Professionalism | is the conduct, aims, or qualities that characterize a professional person. | 4 | |
| 3627368822 | Third-party Payer | is a health insurance company that provides coverage, such as BlueCross BlueShield. | 5 | |
| 3627372030 | Federal Employees' Compensation Act (FECA) | provides civilian employees of the federal government with medical care, survivors' benefits, and compensation for lost wages. | 6 | |
| 3627376423 | Hill-Burton Act | provided federal grants for modernizing hospitals that had become obsolete because of a lack of capital investment during the Great Depression and WWII (1929 to 1945). | 7 | |
| 3627380580 | Copayment | is a provision in an insurance policy that requires the policyholder or patient to pay a specified dollar amount to a health care provider for each visit or medical service received. | 8 | |
| 3627383648 | Clinical Laboratory Improvement Act (CLIA) | legislation established quality standards for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results regard- less of where the test was performed. | 9 | |
| 3627388707 | National Correct Coding Initiative (NCCI) | created to promote national correct coding methodologies and to eliminate improper coding. | 10 | |
| 3627398968 | Patient Protection and Affordable Care Act (PPACA) | focuses on private health insurance reform to provide better coverage for individuals with pre-existing conditions, improve prescription drug coverage under Medicare, and extend the life of the Medicare Trust fund by at least 12 years. | 11 | |
| 3627405540 | Patient Record | documents health care services provided to a patient and includes patient demographic (or identification) data, documentation to support diagnoses and justify treatment provided, and the results of treatment provided. | 12 | |
| 3627413294 | Electronic Health Record | is a more global concept that includes the collection of patient information documented by a number of providers at different facilities regarding one patient. | 13 | |
| 3627426388 | Preventive Services | which are designed to help individuals avoid health and injury problems. | 14 | |
| 3627432487 | Individual Health Insurance | Private health insurance policy purchased by individuals or families who do not have access to group health insurance coverage. | 15 | |
| 3627433801 | Public Health Insurance | Federal and state government health programs (e.g., Medicare, Medicaid, SCHIP, TRICARE) available to eligible individuals. | 16 | |
| 3627437426 | Universal Health Insurance | The goal of providing every individual with access to health coverage, regardless of the system implemented to achieve that goal. | 17 | |
| 3627441919 | Medical Savings Account | allows individuals to withdraw tax-free funds for health care expenses that are not covered by a qualifying high-deductible health plan | 18 | |
| 3627445610 | Primary Care Provider (PCP) | is responsible for supervising and coordinating health care services for enrollees and approves referrals to specialists and inpatient hospital admissions | 19 | |
| 3627450545 | Case Management | involves the development of patient care plans for the coordination and provision of care for complicated cases in a cost-effective manner. | 20 | |
| 3627474686 | Exclusive Provider Organization (EPO) | is a managed care plan that provides benefits to subscribers who are required to receive services from network providers. | 21 | |
| 3627548519 | Integrated Delivery System | is an organization of affiliated providers' sites (e.g., hospitals, ambulatory surgical centers, or physician groups) that offer joint health care services to subscribers. | 22 | |
| 3627551697 | Health Maintenance Organization (HMO) | is an alternative to traditional group health insurance coverage and provides comprehensive health care services to voluntarily enrolled members on a prepaid basis. | 23 | |
| 3627556619 | Accreditation | is a voluntary process that a health care facility or organization (e.g., hospital or managed care plan) undergoes to demonstrate that it has met standards beyond those required by law. | 24 | |
| 3627582799 | Preauthorization | is a review that grants prior approval for reimbursement of a health care service | 25 | |
| 3627584592 | Concurrent review | is a review for medical necessity of tests and procedures ordered during an inpatient hospitalization | 26 | |
| 3627587368 | Discharge planning | involves arranging appropriate health care services for the discharged patient | 27 | |
| 3627596293 | Amendment to the HMO Act of 1973 | Allowed federally qualified HMOs to permit members to occasionally use non-HMO physicians and be partially reimbursed | 28 | |
| 3627600581 | HIPAA | The Health Insurance Portability and Accountability Act of 1996 (HIPAA) created federal standards for insurers, HMOs, and employer plans, including those who self-insure. | 29 |
