MA NCCT-Medical Office Management – Flashcards

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Ethics
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Right and wrong conduct
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Criminal Law
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Laws concerned with offenses against the public and society in general
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Empathy
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an understanding of another's feelings
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Licensure
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A mandatory credentialing process established by law, usually at the state level, that grants the right to practice certain skills and endeavors
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negligence
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the most common medical tort liability
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breach of contract
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The failure, without legal excuse, of a promisor to perform the obligations of a contract.
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breach of confidence
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Where a professional breaches a clients confidence by releasing confidental info
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fraud
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deliberate deception to secure an unfair gain
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deceit
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dishonesty, deception
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plaintiff
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a person who brings an action in a court of law
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tort
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(law) any wrongdoing for which an action for damages may be brought
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defendant
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an individual or group being sued or charged with a crime
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criminal law
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law concerned with public wrongs against society
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contract
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a binding agreement between two or more persons that is enforceable by law
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reasonable care
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actions by a healthcare worker that are considered reasonable as compared to healthcare workers in the same area (field)
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abandonment
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Refers to discontinuing medical care without making sure that another heath-care professional with equal or a higher level of training has taken over patient care.
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litigation
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a legal proceeding in a court
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assault
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any deliberate attempt or threat to inflict bodily injury upon another person and with apparent ability to do so
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libel
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written untruths that are harmful to someone's reputation
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respondeat superior
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"Let the master answer" an employer is vicariously liable for the behavior of an employee working within his or her scope of employment
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duty of care
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the legal obligation of health care workers to patients and, sometimes, nonpatients.
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statute
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a law
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invasion of privacy
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unwelcome and unlawful intrusion into one's private life so as to cause outrage, mental suffering, or humiliation
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slander
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words falsely spoken that damage the reputation of another
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malpractice
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professional wrongdoing that results in injury or damage
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defamation
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act of harming or ruining another's reputation
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consent
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permission to do something
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civil law
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A law that governs relationships between individuals and defines their legal rights.
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statute of limitations
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a statute prescribing the time period during which legal action can be taken
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habeas corpus
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the right not to be held in prison without first being charged with a specific crime
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subpoena
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a court order requiring appearance and/or testimony
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incompetent
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lacking qualification or ability; incapable
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felony
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a crime more serious than a misdemeanor and punishable by imprisonment for more than one year or death
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grievance
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a complaint about a (real or imaginary) wrong that causes resentment and is grounds for action
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res gestae
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latin for Things done; deeds
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locum tenems
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travelling physian
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tecum
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with yourself
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deposition
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testimony under oath
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citation
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A written summons to appear in court
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warrant
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A writ from a court commanding police to perform specified acts
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arbitration
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the process or act of resolving a dispute
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breach of duty
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Failure to use the degree of care required under the circumstances
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battery
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illegal touching of another person
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qui facit per alium facit per se
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He who acts through another acts for himself.
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bioethics
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the branch of ethics that studies moral values in the biomedical sciences
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philosophy
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a belief (or system of beliefs) accepted as authoritative by some group or school
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privileged communication
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information held confidential within a protected relationship
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burden of proof
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the duty of proving a disputed charge
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assumption of risk
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Voluntarily and knowingly subjecting oneself to danger.
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contributory negligence
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An affirmative defense that alleges that the plaintiff, through a lack of care, caused or contributed to his or her own injury
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proximate cause
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something that produces a result, without it the result would no have occurred.
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moral therapy
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philosophy of treatment that emphasized treating mentally ill people with compassion and understanding, rather than shackling them in chains
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precocity
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..., earlier than normal mental development
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suspension
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a temporary debarment (from a privilege or position etc)
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res judicata
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a matter already settled in court
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res ipsa loquitur
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the thing that speaks for itself; a legal doctrine that relates to negligence in which the harm cannot be traced to a specific health care provider or standard but does not normally occur unless there has been a negligent act
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liability
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the state of being legally obliged and responsible
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defamation of character
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Damaging a person's reputation by making public statements that are both false and malicious
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procedure
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a mode of conducting legal and parliamentary proceedings
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admissions
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admitting to the unit
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endorsement
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formal and explicit approval
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forgery
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criminal falsification by making or altering an instrument with intent to defraud
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forbearance
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a delay in enforcing rights or claims or privileges
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HIPAA
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Health Insurance Portability and Accountability Act
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manslaughter
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unlawfully killing another without planning in advance
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First Class Mail
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used for letters, postcards, and postal cards that weigh 13 ounces or less.
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Second Class Mail
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newspapers & periodicals
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Third Class Mail
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Circulars, printed booklets and newsletters up to 16 ounces
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Fourth Class Mail
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used for books, film and sound recordings
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Grammar
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a system of rules in a language
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third party payer
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SOMEONE OTHER THAN THE PT SPOUSE OR PARENT WHO IS RESPONSIBLE FOR PAYING ALL OR PART OF THE PT'S MEDICAL COST
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provider
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Individual or company that provides medical care and services to a patient or the public
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subscriber
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the insured
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claim
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demand for something as rightful or due
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total disability
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in insurance, the insured is determined to be unable to perform the major duties of his or her specific occupation
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time limit
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Number of days allowed to submit a claim (request for payment)
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premium
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payment for insurance
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coinsurance
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part of charges that an insured person must pay for health care services after payment of the deductible amount
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fee-for-service
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Health plan that repays the policyholder for covered medical expenses
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adjuster
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one who investigates insurance claims or claims for damages and recommends an effective settlement
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indemnities
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Benefits that are made in the form of cash payments
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deductables
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Amounts of money that the insured must pay if there is a loss, prior to the insured paying.
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extended benefits
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An interval after a payment is due to the insurance company in which the policy holder may make payments, and still the policy remains in effect.
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catastrophic
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extremely harmful; causing financial or physical ruin
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partial disability
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a disability from an illness or injury that prevents an insured person from performing one or more of the functions of his or her regular job
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permanent disability
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an illness or injury which is expected to continue for the lifetime of the injured worker that to some extent affects his earning capacity
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preexisting condition
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An illness or disorder of a beneficiary that existed before the effective date of insurance coverage.
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non duplication of benefits
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Requires a secondary carrier to reimburse only upto the level of reimbursement the primary carrier would have paid.
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comprehensive
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Covering completely or broadly
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dread disease rider
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A rider added to a policy to provide additional benefits for certain conditions
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waiting period
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A period of time when you are not covered by insurance for a particular problem
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tri care
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A civilian health and medical program of the uniform services.
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medicare
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a federal program of health insurance for persons 65 years of age and older
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medicaid
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health care for the needy
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workers compensation
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A form of insurance paid by the employer providing cash benefits to workers injured or disabled in the course of employment.
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champ va
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FOR VETERANS, AND SPOUSES, AND CHILDREN OF DISABLED VETS OR VETS THAT HAVE DIED
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explanation of benefits
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paper document from a payer that shows how the amount of a benefit was determined
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coordination of benefits
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Eliminates the duplication of payments when an employee, spouse, or dependents have health coverage under two or more plans.
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ledger
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a record in which commercial accounts are recorded
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