Medical Billing & Reimbursement Flashcards

3698900168	Workers Compensation Insurance	Insurance 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 disorders	0
3698910531	Remittance Advice	electronic or paper based report of payment sent by payer to provider	1
3698914040	Medical Malpractice Insurance	liability insurance that covers physicians and other health care professionals for liability claims arising from patient treatment	2
3698920665	Respondeat Superior	employer is liable for the actions and omissions of employees	3
3698926561	Reimbursement Specialists	person who reviews health related claims to determine the medical necessity for procedures or services	4
3698930867	preauthorization	prior approval	5
3698933086	medical necessity	linking procedure to a condition needed to perform that procedure or service	6
3698936425	hold harmless claws	patient isn't responsible for paying what the insurance plan denies	7
3698940170	EOB	Explanation Of Benefits	8
3698942243	CMS	Centers for Medicare and Medicaid Services	9
3698944909	AHIMA	American Health Information Management Association	10
3698947358	AAPC	American Academy of Professional Coders	11
3698957803	third-party payer	health insurance company that provides coverage such as BCBS	12
3698960052	PHR	Personal Health Record	13
3698961610	per diem	payment per day	14
3698961623	Medicare	reimburses health care services to American's over the age of 65	15
3698965510	Medicaid	state sponsored that pays health insurance	16
3698967036	Group Health Insurance	health care coverage subsidized by employers	17
3698969729	Fee Schedule	list of predetermined payments for health care services provided to patients	18
3698971878	EHR	Electronic Health Record	19
3698973714	Deductible	amount for which the patient is financially responsible before an insurance policy provides coverage	20
3698976860	Copayment	insurance policy that requires the policyholder or patient to pay a specified dollar amount to health care provider	21
3698982127	Coinsurance	percentage the patient pays for covered services after the deductible has been met	22
3698985755	CMS-1500	form used to submit Medicare claims	23
3698988014	CHAMPVA	Civilian Health and Medical Program of the Department of Veterans Affairs	24