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Medical Billing & Reimbursement Flashcards

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3698900168Workers Compensation InsuranceInsurance program mandated by federal & state governments, that requires employers to cover medical expenses & loss of wages to workers who are injured on the job or develop job related disorders0
3698910531Remittance Adviceelectronic or paper based report of payment sent by payer to provider1
3698914040Medical Malpractice Insuranceliability insurance that covers physicians and other health care professionals for liability claims arising from patient treatment2
3698920665Respondeat Superioremployer is liable for the actions and omissions of employees3
3698926561Reimbursement Specialistsperson who reviews health related claims to determine the medical necessity for procedures or services4
3698930867preauthorizationprior approval5
3698933086medical necessitylinking procedure to a condition needed to perform that procedure or service6
3698936425hold harmless clawspatient isn't responsible for paying what the insurance plan denies7
3698940170EOBExplanation Of Benefits8
3698942243CMSCenters for Medicare and Medicaid Services9
3698944909AHIMAAmerican Health Information Management Association10
3698947358AAPCAmerican Academy of Professional Coders11
3698957803third-party payerhealth insurance company that provides coverage such as BCBS12
3698960052PHRPersonal Health Record13
3698961610per diempayment per day14
3698961623Medicarereimburses health care services to American's over the age of 6515
3698965510Medicaidstate sponsored that pays health insurance16
3698967036Group Health Insurancehealth care coverage subsidized by employers17
3698969729Fee Schedulelist of predetermined payments for health care services provided to patients18
3698971878EHRElectronic Health Record19
3698973714Deductibleamount for which the patient is financially responsible before an insurance policy provides coverage20
3698976860Copaymentinsurance policy that requires the policyholder or patient to pay a specified dollar amount to health care provider21
3698982127Coinsurancepercentage the patient pays for covered services after the deductible has been met22
3698985755CMS-1500form used to submit Medicare claims23
3698988014CHAMPVACivilian Health and Medical Program of the Department of Veterans Affairs24

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