13144229767 | Stereotype | A generalized belief about a group of people | 0 | |
13144232904 | Out of Pocket expense | Specific amount of money that you pay when insurance only covers a portion of cost | 1 | |
13144236704 | Encounter form | a list of the procedures and charges for a patient's visit | 2 | |
13144241022 | Electronic Claim | alternative to paper claim, submitted to payer directly by physician or clearinghouse. Are usually paid faster. Most electronic claims software have self-editing features that detect and report entries that may cause to be rejected, such as invalid codes or incomplete claims | 3 | |
13144241023 | Paper Claim | traditional method used by providers for submission of charges to ins co's. The most commonly used form is the CMS-1500. Few plans will still accept the physicians encounter forms or superbill and Medicare will only accept claims onthe CMS-1500 | 4 | |
13144250232 | Reimbursement | amount paid to patient toward the cost of healthcare services | 5 | |
13144255470 | Verification of benefits | Determination of whether patient is eligible for coverage of services | 6 | |
13144258842 | managed care referral | a referral from physician to seek treatment from another specialty provider | 7 | |
13144276103 | preauthorization | Prior approval for treatment and procedures | 8 | |
13144300397 | secondary insurance | second payer on a claim | 9 | |
13144304156 | EDI | Electronic Data Interchange | 10 | |
13144304157 | CMS | Centers for Medicare and Medicaid Services, currently administers the medicare program | 11 | |
13144312672 | CHAMPVA | Coverage for veterans with service related injuries | 12 | |
13144320010 | WC | Workman's Comp, an insurance plan that provides coverage for those injured on the job | 13 | |
13144331823 | Tricare | U.S. government health insurance plan for all military personnel | 14 | |
13144340450 | Medicare Part A | Covers hospital care | 15 | |
13144340452 | Medicare Part B | Covers physician services | 16 | |
13144344177 | Medicare Part C | Managed care option | 17 | |
13144357965 | Medicare Part D | coverage for medications | 18 | |
13144364498 | Filing Limits | The amount of time allowed to file a claim for payment | 19 | |
13144375446 | Supporting Claim Documentation | reports, or test results that can be used to back up why a test or procedure or office visit was requires, Lab results, X ray, chart note | 20 | |
13144386911 | Clean claim | health insurance claim form that has been completed correctly without any errors or omissions | 21 |
Medical Insurance billing test Flashcards
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