Introduction to Medical Billing & Coding Flashcards

4288610098	WHO	World Health Organization	0
4288610099	ICD	International Classification of Diseases	1
4288610100	Who developed ICD to:	collect data for statistical purposes	2
4288610101	CPT	Current Procedural Terminiology	3
4288610102	CPT was developed by...	American Medical Association	4
4288610103	AMA	American Medical Association	5
4288610104	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
4288610105	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
4288610106	Medicaid is funded by ....	funded by the federal government, Medicaid is run by the state where coverage may vary.	8
4288610107	Medicaid is run by...	funded by the federal government, Medicaid is run by the state where coverage may vary.	9
4288610108	HIPAA	Health Insurance Portability and Accountability Act of 1996	10
4288610109	HIPAA regulates	andates regulations that govern privacy, security, and electronic transaction standards for health care information	11
4288610110	PIP	Personal Injury Protection	12
4288610111	PIP	Reimburses medical expenses for covered individuals, regardless of fault, for treatment due to an auto accident.	13
4288610112	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
4288610113	Disability insurance is managed by	Social Security	15
4288610114	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
4288610115	OSHA	Occupational Safety and Health Administration	17
4288610116	OSHA protects	protect all employees against injuries from occupational hazards in the workplace	18
4288610117	OSHA is an agency under	U.S. Department of Labor	19
4288610118	HMO	Health Maintenance Organization	20
4288610119	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
4288610120	Networks are made up of	providers that have agreed to lower their rates for plan members and also meet quality standards	22
4288610121	Lower insurance premiums	HMO	23
4288610122	PPO	Preferred Provider Organization	24
4288610123	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
4288610124	Higher insurance premiums	PPO	26
4288610125	low or no deductible	HMO	27
4288610126	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
4288610127	Blue Cross Policy	plan initiated by Baylor University to guarantee Dallas teachers 21 days of hospital care for $6 a year, in 1929	29
4288610128	DRG stands for	Diagnosis Related Group	30
4288610129	DRG is	statistical system of classifying any inpatient stay into groups for the purposes of payment	31
4288610130	Copayment is abbreviated	Co-Pay	32
4288610131	Co-Pay	in an insurance policy and paid by an insured person each time a medical service is accessed	33
4288610132	BCBS	Blue Cross Blue Shield	34
4288610133	Clinical Laboratory Improvements Act	CLIA	35
4288610134	CLIA	regulates all laboratory testing (except research) performed on humans in the U.S.	36
4288610135	AMA is for	medical organization for professionals and medical students	37
4288610136	Third Party Administrator	TPA	38
4288610137	TPA	An organization that administrates group insurance policies for an employer	39
4288610138	Civilian Health and Medical Program of the Department of Veterans Affairs	CHAMPVA	40
4288610139	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
4288610140	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
4288610141	Tricare	military insurance	43
4288610142	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