Introduction to Medical Billing & Coding Flashcards

3255408271	WHO	World Health Organization	0
3255411188	ICD	International Classification of Diseases	1
3255414014	Who developed ICD to:	collect data for statistical purposes	2
3255415365	CPT	Current Procedural Terminiology	3
3255423377	CPT was developed by...	American Medical Association	4
3255423378	AMA	American Medical Association	5
3255429244	Medicare	federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease	6
3255433723	Medicaid	A 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
3255437579	Medicaid is funded by ....	funded by the federal government, Medicaid is run by the state where coverage may vary.	8
3255439797	Medicaid is run by...	funded by the federal government, Medicaid is run by the state where coverage may vary.	9
3255444216	HIPAA	Health Insurance Portability and Accountability Act of 1996	10
3255448098	HIPAA regulates	andates regulations that govern privacy, security, and electronic transaction standards for health care information	11
3255453058	PIP	Personal Injury Protection	12
3255455777	PIP	Reimburses medical expenses for covered individuals, regardless of fault, for treatment due to an auto accident.	13
3255461262	Disability Insurance	offers income protection to individuals who become disabled for a long period of time, and as a result can no longer work during that time period	14
3255467748	Disability insurance is managed by	Social Security	15
3255471891	Disability insurance is paid if	Was under the care and treatment of a licensed provider during initial disability and continues care with the same	16
3255474343	OSHA	Occupational Safety and Health Administration	17
3255476807	OSHA protects	protect all employees against injuries from occupational hazards in the workplace	18
3255479650	OSHA is an agency under	U.S. Department of Labor	19
3255490909	HMO	Health Maintenance Organization	20
3255497776	HMO gives access to what doctors and nurses	Those within their network, care is covered only if you see a doctor within their network (few opportunities for out of network docs)	21
3255503853	Networks are made up of	providers that have agreed to lower their rates for plan members and also meet quality standards	22
3255513963	Lower insurance premiums	HMO	23
3255519923	PPO	Preferred Provider Organization	24
3255528020	PPO gives you access to what doctors and nurses	Those within and outside of network, but better cost if you see an in-network doc	25
3255536651	Higher insurance premiums	PPO	26
3255541440	low or no deductible	HMO	27
3255545531	HMO Act of 1973	authorized 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 area	28
3255548831	Blue Cross Policy	plan initiated by Baylor University to guarantee Dallas teachers 21 days of hospital care for $6 a year, in 1929	29
3255553882	DRG stands for	Diagnosis Related Group	30
3255553883	DRG is	statistical system of classifying any inpatient stay into groups for the purposes of payment	31
3255560310	Copayment is abbreviated	Co-Pay	32
3255561837	Co-Pay	in an insurance policy and paid by an insured person each time a medical service is accessed	33
3255571646	BCBS	Blue Cross Blue Shield	34
3255571647	Clinical Laboratory Improvements Act	CLIA	35
3255580595	CLIA	regulates all laboratory testing (except research) performed on humans in the U.S.	36
3255586122	AMA is for	medical organization for professionals and medical students	37
3255588297	Third Party Administrator	TPA	38
3255588298	TPA	An organization that administrates group insurance policies for an employer	39
3255594366	Civilian Health and Medical Program of the Department of Veterans Affairs	CHAMPVA	40
3255597440	CHAMPVA	comprehensive health care program in which the Department of Veterans Affairs (VA) shares the cost of covered health care services and supplies with eligible beneficiaries	41
3255605607	Who are CHAMPVA beneficiaries	The 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
3255617219	Tricare	military insurance	43
3255627451	Who is eligible for Tricare	Active 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 spouses	44