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Introduction to Medical Billing & Coding Flashcards

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4288610098WHOWorld Health Organization0
4288610099ICDInternational Classification of Diseases1
4288610100Who developed ICD to:collect data for statistical purposes2
4288610101CPTCurrent Procedural Terminiology3
4288610102CPT was developed by...American Medical Association4
4288610103AMAAmerican Medical Association5
4288610104Medicarefederal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease6
4288610105MedicaidA 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
4288610106Medicaid is funded by ....funded by the federal government, Medicaid is run by the state where coverage may vary.8
4288610107Medicaid is run by...funded by the federal government, Medicaid is run by the state where coverage may vary.9
4288610108HIPAAHealth Insurance Portability and Accountability Act of 199610
4288610109HIPAA regulatesandates regulations that govern privacy, security, and electronic transaction standards for health care information11
4288610110PIPPersonal Injury Protection12
4288610111PIPReimburses medical expenses for covered individuals, regardless of fault, for treatment due to an auto accident.13
4288610112Disability 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
4288610113Disability insurance is managed bySocial Security15
4288610114Disability insurance is paid ifWas under the care and treatment of a licensed provider during initial disability and continues care with the same16
4288610115OSHAOccupational Safety and Health Administration17
4288610116OSHA protectsprotect all employees against injuries from occupational hazards in the workplace18
4288610117OSHA is an agency underU.S. Department of Labor19
4288610118HMOHealth Maintenance Organization20
4288610119HMO 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
4288610120Networks are made up ofproviders that have agreed to lower their rates for plan members and also meet quality standards22
4288610121Lower insurance premiumsHMO23
4288610122PPOPreferred Provider Organization24
4288610123PPO gives you access to what doctors and nursesThose within and outside of network, but better cost if you see an in-network doc25
4288610124Higher insurance premiumsPPO26
4288610125low or no deductibleHMO27
4288610126HMO 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
4288610127Blue Cross Policyplan initiated by Baylor University to guarantee Dallas teachers 21 days of hospital care for $6 a year, in 192929
4288610128DRG stands forDiagnosis Related Group30
4288610129DRG isstatistical system of classifying any inpatient stay into groups for the purposes of payment31
4288610130Copayment is abbreviatedCo-Pay32
4288610131Co-Payin an insurance policy and paid by an insured person each time a medical service is accessed33
4288610132BCBSBlue Cross Blue Shield34
4288610133Clinical Laboratory Improvements ActCLIA35
4288610134CLIAregulates all laboratory testing (except research) performed on humans in the U.S.36
4288610135AMA is formedical organization for professionals and medical students37
4288610136Third Party AdministratorTPA38
4288610137TPAAn organization that administrates group insurance policies for an employer39
4288610138Civilian Health and Medical Program of the Department of Veterans AffairsCHAMPVA40
4288610139CHAMPVAcomprehensive health care program in which the Department of Veterans Affairs (VA) shares the cost of covered health care services and supplies with eligible beneficiaries41
4288610140Who 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
4288610141Tricaremilitary insurance43
4288610142Who 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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