question

APC

answer

ambulatory payment classification; a payment methodology in which services paid under the prospective payment system are classified into groups that are similar clincially and in terms of the resources they require; a payment rate is est. for each APC

question

APR

answer

annual percentage rate; one of the elements of disclosure required by the Truth in lending act

question

ASSIGNMENT OF BENEFITS

answer

a written authorization, signed by the policyholder(or the patient, in the absence of the policyholder) to an insurance company, to pay benefits directly to the provider; when assigment is not accepted, the payment will be sent to the patient and the provider will have to collect it.

question

ATB

answer

aged trial balance; a resource for internal collection efforts.

question

A T S D R

answer

Agency for Toxic Substances and Disease Registry; one of the DHHS Operating Divisions

question

Average Daily Census

answer

The average number of inpatients maintained in the hospital each day for a specific period ot time.

question

Average Days of Revenue in Accounts Receivable

answer

also knos as Accounts Receivable (AR) Days Outstanding; an estimate, using average current revenues, of the days required to turn over the account rec. under normal operating coditions; in simple terms, this is an estimate of the time needed to collect the accts. rec.

question

Bad Debt

answer

an uncollectible account resulting from the extension of credit

question

Beneficiary

answer

A person who has healthcare insurance through Medicare.

question

Birthday Rule

answer

A rule to determine coordination for benefits for a child covered by both parents; it dictates that the parent with the first birthday in the calendar year will provide the primary coverage; if both parents happen to have the same birthday; the plan that has covered a parent longer pays first.

question

Black Lung Benefits Act

answer

legislation which provides for medical treatment for coal mines totally disabled from black lung disease.

question

Bressers

answer

a cross-reference directory used in skip tracing.

question

CAH Critical Access Hospital

answer

critical access hospital a non profit hospital located in a state that has established a medicare Rural Hospital Flexibility Program; it must have 25 or fewer beds and an ALOS of 96 hr or less, be located a certain minimum distance from other hospitals, and furnish 24 hour emergency care services; Medicare pays CAHs for most inpatient and outpatient services on the basis of reasonable cost

question

capitation

answer

a method of payment in which a provider is paid a set dollar amount for each patient for a specific time period, and that payment covers all care the group of patients receives for that period, no matter the actual charges.

question

Case Management UR Review

answer

also known as utilization review (UR) an area that performs critical tasks during registration and a patient's stay, such as reducing unnecessary admissions, managing the approved LOS; ensuring an appropriate level of care for the patients condition; serving as a liaison with the primary and spec phys; serving as a liaison with the ins. carrier; obtaining approvals, when clinically necessary, for pre-certification; recert; advising the patient of dischare; and assisting with appeals for denials, when applicable

question

CDC

answer

Centers for Diseas Control and Prevention; one of the DHHS Operating Divisions

question

CDM

answer

charge description master; the chargemaster or master pricing list that includes services, supplies, devices, and medication charges for inpatient or outpatient services by a healthcare facility.

question

CERT

answer

Comprehensive Error Rate Testing

question

CHAMPUS

answer

Civilian Health and Medical Programs of the Uniformed Services; the programs replaced by TRICARE to cover healthcare for active duty and retired members of the uniformed services, their families, and survivors.

question

Chapter 7

answer

a type of bankruptcy applying to individuals and businesses that cannot pay their debts based on their income; except for exempty property as defined by state laws, the debtor's assets are auctioned to satisy creditor claims; about 70% of all bankrupcy claims are filed under Chapter 7

question

Chapter 11

answer

a type of bankrupcy frequently referred to as a \"reorganization\" it gives a distressed busiiness a reprieve from creditor claims while it continues to function and works out a repayment plan.

question

Chapter 12

answer

a type of bankruptcy for a family farmer with \"regular annual income\".

question

Chapter 13

answer

a type of bankruptcy designed for individuals with regular income who desire to pay their debts, but currently are unable to do so; the debtor, under court supervision and protection, may propose and carry out a repayment plan under which creditors are paid over an extended period of time.

question

chargemaster

answer

also known as charge description master (CDM); the master pricing list that includes services, supplies, devices, and medication charges for inpatient or outpatient services by a healthcare facility.

question

charity care

answer

service provided that is never expected to result in cash flow.

question

CLIA

answer

the Clinical Laboratory Improvement Amendment of 1988; legislation requiring all clinical laboratory services furnished to Medicare beneficiaries to be performed by a provider who has CLIA certificate.

question

CMP

answer

civil monetary penalty.

question

CMS

answer

Centers for Medicare and Medicaid Services; one of the DHHS Operating Divisions.

question

CMS 1450

answer

another name for the UB-04 uniform bill form.

question

CMS 1500

answer

the billing form used to submit physician and professional service claims to Medicare.

question

CO

answer

Compliance Officer

question

COB

answer

coordination of benefits; the determindation of which plan or insurance policy will pay first if two health plans or insurance policies cover the same benefits.

question

Common Working File (C W F)

answer

a CMS file that contains Medicare patient eligibility and utilization data.

question

conditional payment

answer

a payment made when antoher payer is responsible, but the claim is not expected to be paid promptly (usually within 120 days from receipt of the claim); it prevents the beneficiary from having to pay out of pocket; Medicare then hasx the right to recover any payments that should have been made by another payer.

question

Consumer Credit Protection Act

answer

The first general federal consumer protection legislation; its provisions include the Truth in Lending Act, the Fair Credit Billing Act, the Fair Credit Reporting Act, and the Fair Debt Collection Practices Act.

question

Courtesy discharge

answer

a type of discharge in which a patient's financial considerations have been met so he or she is allowed to leave the hospital without going thru the usual formalities, the patient is billed at a later date.

question

CPT

answer

Current Procedural Terminology; a system of descriptive terms and five-digit numeric codes that are used primarily to identify medical services and procedures furnished by physicians and other healthcare professionals.

question

CPU

answer

Central processing unit.

question

C R A

answer

credit reporting agency.

question

custodial care

answer

care that is primarily for the purpose of meeting personal needs; person without professional training may provide custodial care; it is not covered by Medicare

question

data mailer

answer

a system-generated, free form statement that is used to communicate the status of a patient's account and/or to bill the patient for unpaid amount remaining on the account.

question

DHHS

answer

Department of Health and Human Services; the US government's principal agency for protecting the health of all Americans and providing essential human services; it is also the federal government's largest grant-making agency.

question

discharge of debtor

answer

a potential outcome of bankruptcy that is releases the guarantor/patient from financial responsibility of any and all account balances listed on the bankruptcy petition; the account balance is to be written off to the appropriate transaction code.

question

dismissal

answer

a court ruling whereby a bankruptcy is dismissed; the most common reason for dismissal is the failure of the debtor to follow thru on the filing process and on payment to the attorney, and failure to provide requested documentation upon dismissal of a bankruptcy, a creditor can bill the debtor directly, refer the account to a collection agency, or pursue litigation.

question

D M E

answer

durable medical equipment, such as wheelchairs, hosptial beds, oxygen, and walkers.

question

D M E P O S

answer

durable medical equipment, prosthetics, orthotics, and supplies.

question

DOJ

answer

Department of Justice,; one of the entities, along with the Office of Inspector General (OIG), that coordinates fraud and abuse control.

question

D S M T

answer

Diabetes Self-Management Training.

question

dual eligible

answer

an individual who is entitled to Medicare Part A and/or Part B, and also eligible for some form of Medicaid benefit.

question

Durable Power of Attorney for Healthcare

answer

also known as healthcare Power of Attorney; a document that designates someone else (known a s a healthcare surrogate, agent, or proxy) to make decisions on the patient's behalf if he or she is unable to do so.

question

E & M

answer

evaluation and management; both the process of and the charge for examining a patient and formulating a treatment plan.

question

E G H P

answer

Employer Group Health Plan

question

emancipation

answer

a process by which a minor is freed from parental control based on specific criteria (the minor no longer requires parental guidance or financial support, fathered or gave birth to a child, or has reached the age of majority).

question

Emergency Medical Treatment and Active Labor Act (EMTALA)

answer

also knows as the Federal Anti-dumping Statute; legislation enacted in 1986 in response to concerns that hospitals were refusing to treat patients without insurance and even transferring them to other facilities and leaving them there, sometimes without notifying the receiving facility.

question

E O B

answer

Explanatin of Benefits; the former name for the Medicare Summary Notice, which is a remittance advice.

question

Evaluation and Management (E & M)

answer

both the process of and the charge for examining a patient and formulating a treatment plan.

question

Fair Credit Billing Act

answer

an amendment to the Truth in Lending Act; it protects consumers from inaccurate or unfair practices by issuers of open-ended credit, requires creditors to inform debtors of their rights and of the presponsibilities of the creditor, and has as its principle thrust to provide for prompt settlement of billing disputes.

question

Fair Credit Reporting Act

answer

defines what information from \"consumer reports\" can be used, by whom, and when; it provides the maximum protection of consumer's right to privacy and confidentiality of credit reports.

question

Fair Debt Collection Practices Act (FDCPA)

answer

legislation enacted as the result of evidence that debt collectors were using abusive, deceptive, and unfair, collection practices; it imposes strict limitations and prohibitions on debt collection practices

question

false

answer

a type of skip generally caused by clerical error at the time of registration, such as transposed numbers in the street address, an incorrect zip code, or incomplete information.

question

False Claims Act

answer

legislation that prohitits making a false record or statment to get a false/fraudulent claim paid by the government, submission of false, fraudulent claims, and conspiring to false,fraudulent claims paid by the gov.

question

F D A

answer

Food and Drug Administration; one of the DHHS Operating Divisions.

question

Federal Anti-Dumping Statute

answer

another name for the Emergency Medial Treatment and Active Labor Act (EMTALA); legislation enacted in 1986 in response to concerns that hospitals were refusing to treat patients without insurance and even transferring them to other facilities and leaving them there, sometimes without notifying the receiving facility.

question

FOIA

answer

Freedome of Information Act.

question

fraud

answer

the intentional or illegal deception or misrepresentation made for the purpose of personal gain, or to harm or manipulate another person or organization; fraud includes incorrect reporting of diagnosis and procedure codes to maximize payment, accepting kickbacks, the routine waiver of deductible and coinsurance amounts. etc.

question

GAAP

answer

generally accepted accounting principles.

question

HCFA

answer

Health Care Financing Administration; the former name for the Centers for Medicare and Medical Services.

question

HCPCS

answer

Healthcare Common Procedure Coding System; the federal government equivalent to the CPT system.

question

H I C N

answer

Medicare Health Insurance Claim Number

question

Hill-Burton Act

answer

the Hospital Survey and Construction Act; legislation designed to assist hospitals by providing loans for construction projects; once the hospitals were operationl, the funds that wer borrowed were to be paid back in the form of charity; also known as Title I.

question

H I P A A

answer

Health Insurance Portability and Accountability Act of 1996; also known as the Kennedy-Kassenbaum Bill; it created federal standards for insurers, HMOs, and employer plans including those who are self-insured.

question

H M O

answer

Health Maintenance Organization; one of five types of Medicare Advantage Plans in which members must generally get healthcare from providers in the plan's network.

question

home health care

answer

preventive, supportive, rehabilitative, or therapeutic care provided to a patient at home, to be reimbursed by the Medicare program, a physician must certify that the patient is home bound, in need of skilled nursing care on an intermittent basis for physical, occupational, and/or speech therapy, with an established plan of care.

question

hospice care

answer

coordinated, palliative care provided to terminally ill patients and their families by nonprofit organizations.

question

HRSA

answer

Health Resources and Services Administration; one of the DHHS Operating Divisions.

question

ICD

answer

International Classification of Diseases; a standard transaction set used for 1) chief complaint or diagnosis for professional services and inpatient procedures, and 2 ) for diagnosis and procedure codes for professional and technical services for both inpatient and outpatient procedures.

question

IEQ

answer

Initial Enrollment Questionnaire; a questionnaire, mailed about three months before patients become entitled to Medicare; it asks about any other healthcare coverage that may be primary to Medicare.

question

I H S

answer

Indian Health Service; one of the DHHS Operating Divisions.

question

implied conset-by law

answer

consent that occurs in a situation where the patient is unconscious and is taken to the emerg. room; the law allows treating the patient.

question

implied consent- in fact

answer

consent by silence; the patient implies consent to the treatment by not objecting.

question

imprest

answer

petty cash

question

indigent

answer

an individual with no means of paying for services or treatments; who is not elegible for Medicaid or another public assistance program.

question

informed consent

answer

consent given when the risks and benefits of a treatment are understood and the patient makes an informed decision whether to receive that treatment.

question

Initial Enrollment Questionnaire (IEQ)

answer

a questionnaire mailed about three months before patients become entitled to Medicare; it asks about any other healthcare coverage that may be primary to Medicare.

question

initial preventive physical examination (IPPE)

answer

the \"Welcome to Medicare Physical Exam\" that is offered to each beneficiary once in a lifetime.

question

intentional

answer

a type of skip in which someone avoids paying bills by changing his or her residency and failing to leave a forwarding address, purposely chaning his or her name, or intentinally giving false information.

question

involuntary bankrupcy

answer

a type of bankruptcy in which a debtor can be placed under chapter 7 or 11 if the debtor has 12 or more creditors, three of which have claims in excess of 5,000 each and are willing to force the issue or one creditor owed at least $10,775.

question

I P P S

answer

Inpatient Prospective Payment System.

question

JCAHO

answer

Joint Commission on Accreditation of Healthcare Organizations; the former name for the Joint Comm.

question

Joint Commission, (The TJC)

answer

the organization that accredits hospitals; formerly call the Joint Commission on Accrediation of Healthcare Organizations (JCAHO); accrediation is extermely important for hospitals as it is a requirement of participation in the Medicare program.

question

judgment

answer

a legally verified claim against a debtor; a legal right to collect a debt that can be used to obtain a lein.

question

lien

answer

a record claim against real or personal property; if the property is sold, the creditor mut be paid out of the proceeds of the sale.

question

living will

answer

a document that specifies what treatments a patient does and does nto wish to receive; it means that difficult decisions about future care are made while the person is alert; patients can choose the circumstances under which they will die; and patient's desires regarding organ donation are made known.

question

long term care

answer

care generally provided to the chronically ill or disabled in a nursing facililty or rest home; among the services provided by nursing facilities are 24 hour nur care; rehabilitative services such as physical, occupational, and speech therapy; and assistance with daily activities like eating, bathing, and dressing.

question

LTR

answer

life time reserve

question

M A A C

answer

maximum allowable actual charge.

question

M C E Medicare Code Editor

answer

Medicare Code Editor software that edits claims to detect incorrect billng data that is bein submitted.

question

M D C

answer

majro diagnostic category; one of 25 groups of DRGs (diagnosis related groups)

question

M D S

answer

Minimum Data Set; a part of the federally required process for clinical assessment of all residents in Medicare or Medicaid certified nursing homes the MDS then determins the Resource Utilization Group (RUG) and henc the payment.

question

Medicaid

answer

a ealh insurance program for the elderly (age 65 or older) and those under age 65 who have permanent disabilities or end stage renal disease (ESDR)

question

Medicare

answer

a health insurance prorgram for the elderely (age 65 or older) and those under age 65 who have permanent disabilities or end stae renal disease (ESDR)

question

Medicare Advantage Plans

answer

another name for Medicare Part C; managed care coverage provided by private insurance companies approved by Medicare.

question

Medicare Participating Physician Program

answer

a program that enable providers to accept assignment of benefits.

question

Medicare Secondary Payer M S P

answer

lasws that shifted costs from the Medicare program to other sources of payment, MSP information is gathered from each beneficiary to determine the proper coordination of benefits.

question

Medicare Summary Notice (M S N)

answer

a remittance advice ; formerly call the Explanation of benefits (EOB)

question

Medigap

answer

also known as Medicare supplemental insurance; health insurance sold by private insurance companies to fill in the \"gaps\" in coverage (like deductibles, coinsurance, and copayments) under the Original Medicare Plan; some Medigap policies also cover benefits that Medicare doesn't cover, like emergency healthcare while traveling outside the US.

question

MIC

answer

Medicaid Integrity Contractors; review, audit, and educate providers to combat fraude and abuse.

question

midnight census

answer

the number of patients in the hospital at midnight. forumula : previous nights midnight census - any discharges+ admissions, and +/- any status changes.

question

MSP Questionnaire

answer

a questionnaire completed on an ongoing basis to help determine if medicare is primary or secondary; it asks about employment, accidents, and several other relevant subjects.

question

M T F

answer

Military Treatment Facility.

question

M U E

answer

Medcially Unlikely Edit; an automated edit for HCPCS/CPT codes for services rendered by a provider to a single beneficiary on the same date of service; it helps to prevent inappropriate payments due to clerical entries and incorrect coding based on anatomic considerations.

question

M V P S

answer

Medicare Volume Performance Standard; the element of the Resouce Based Relative Value Scale (RBRVS) for the reates of increase in Medicare expenditures for physician services.

question

N A S (Non-Availability Statement)

answer

a requirement before any non emergent inpatient services may be provided to a TRICARE Extra or Standard eligible beneficiary by a non-Miliary Treatment Facility *(MTF)

question

NCCI ( National Correct Coding Initiative

answer

a Medicare initiative to promote correct coding methodologies and strive to eliminate impropoer coding; itdentifies mutually exclusive CPT-4 and HCPCS codes or those that should not be billed together.

question

NIH

answer

National Institutes of Health; one of the DHHS Operating Divisions

question

non-standard claim

answer

a claim with extraneous attachments in lieu of data entered correctly in the claim form.

question

N P P

answer

non physician ptractitioner

question

NUBC (National Uniform Billing Committe)

answer

the entity that determined the data elements used in the UB-04 final format as a cooperative effort with the American Hospital Assocation (AHA)

question

OBRA

answer

Omnibus Budget Reconciliation Act (OBRA) of 1989; it provided for the Resource Based Relative Value Scale (RBRVS) as a payment reform provision.

question

observation

answer

services furnised on a hosp. premises, including use of a bed and periodic monitoring by a hosp. nursing staff; services should be reasonable and necessary to evaluate an outpatient condition to assess the need for admission to the hospital; observation services usually do not exceed 24 hrs however, ther is no jrly limit on the extent to which they may be used (CMS has indicated that instances would be rare that a ptient would remain in observation for more than 48 hrs)

question

office

answer

care provided in a ptractitionr's place of business; a practitioner may be a medical doctor, podiatrist, chiropractor, dentist, advanced practice nurse, registered dietitian, physical therapsit, psychologist, or one of many other professions.

question

OIG

answer

Office of Inspector General; one of the entities, along with the Department of Justice, that coordiantes fraud and abuse control; it alos has identified seven elements of a compliance plan.

question

ordering physician

answer

a physician who orders non physician services for a patient, such as a diagnostic x-rays

question

outpatient

answer

treatment received at a hospital, clinic, or despensary by someone who is not hospitialized; emergency room patients, ambulatory patients, clinic patients, and same day surg. patients are all examples

question

Part A

answer

the hospital insurance component of Medicare that helps pay for medically necessary inpatient hospitalization, care in a SNF following a three-day hospital stay, home health care, hospice care, and blood

question

Part B

answer

the medical insurance component of medicare that helps pay for doctor services, outpatient hospital care, and some other medical services that Part A does not cover (such as the services of PT and OT, and some home health care)

question

Part C

answer

also known as Medicare Advantage Plans; managed care coverage provided by private insurance companies approved by Medicare.

question

Part D

answer

the component of Medicare that helps pay for prescription drugs.

question

P A T

answer

pre-admission testin; the diagnostic medial screening of patients in advance of surgical or invasive procedures to determine hospitalization and/or surgical suitability.

question

Patient Bill of Rights

answer

a development by the American Medical Association that guarantees a patient the right to receive courteous, considerate,respectful treatment in a clean/safe environment; appropriate healthcare; information about his/her health treatment plan in a way that he or she understands; a continuity of care; confidentiality privacy;participation in planning care and tgreatment;refuusal of care; use of grieveance mechanisms; treatment wihout discrimination;an itemized bill and explanation of all charges; and review of the medical recor and/or copy at reasonable fee.

question

P C P

answer

Primary Care Physician.

question

per diem

answer

Latin for \"for each day\" a payment methodology in which providers are paid a predetermined amount for each day an inpatient is in the facility, regardless of actual charges or costs incurred.

question

percentage of occupancy

answer

the ratio of actual patient days to the maximum patient days as determined by bed capacity; a low percentage of occupancy indicates inefficiency while a percentage that is too hight will mean difficulty finding available beds, long hold time in ER etc.

question

physician extender

answer

physician assistant, nurse practioner, etc

question

PPO

answer

Preferred Provider Organization; one of five types of medicar Advantage Plans in which members can see any doctor or provider that accepts medicare and they don't need a referral to see a specialist

question

PPS

answer

Prospective payment system

question

pre-certification

answer

the process of obtaining authorization from an insurance company review organization approving the medical necissity of a hsopitalization.

question

Privacy Act of 1974

answer

legislation that governs patient confidentiality and provides safeguards against an invasion of privacy through the misue of records by federal agencies.

question

P S A

answer

Physician Scarcity Area.

question

P S D A

answer

Patient Self Determination Act of 1990; legislation that ensures that patients understood their right to participate in decisions about their own healthcare.

question

Q I O

answer

Quality Improvement Organization; part of a CMS program to monitor and improve utilization and quality of care for Medicare beneficiaries.

question

R B R V S

answer

Resource Based Relative Value Scale. A payment reform provision comprising three major elements: a fee schedule for payment of phys. services, based on the relative value unit (RVU); the Medicare volume Performance Standard (MVPS) for the rates of increase in Medicare expenditures for physician services; and limits on the amount non-participating physicians can charge beneficiaries, referred to as the limiting charge.

question

referring physician

answer

a physician who requests an item or service for a beneficiary for which payment may be made under Medicare.

question

Regulation Z

answer

antoher name for Title I of the consumer Credit Protection Act, or the Truth in Lending Act; it requires disclosure of information before credit is extended.

question

remittance advice

answer

antoher name for the medicare summary Notice; formerly called the Medicare Explanation of Benefits (EOB)

question

Resource Utilization Group (RUG)

answer

a system to determine the payment rate for most skilled nursing care; the provider completes the Minimum Data SSet as part of the rederally required process for clinical assessment of all residents in Medicare-or Medicaid-certified nursing homes; the MDS then determines the RUG and hence the payment; the patient is reevaluated at intervals during his or her stay and the RUG rate may be changed.

question

respite care

answer

short term temporary custiodal care that allows a famiily member or other unpaid caregiver to get relief from caring for a physically frail or dependant person at home.

question

R V U

answer

Relative value unit; the basis for the fee schedule for payment of physician services that is one of the elements of the Resource Based Relative Value Scale (RBRVS)

question

SAMHSA

answer

Substance Abuse and mental Health Services Administration; one of the DHHS Operating Divisions

question

SCHIP

answer

the State Children's Health Insurance Program; a program for children whose parents have too much money to be eligile for medicaid, but not enough to buy private insurance; it is jointly financed by the federal and state governments, and administered by the states.

question

skip

answer

a debtor who cannot be located by a creditor; ther are three type intentional; unintentional, and false.

question

S N F

answer

skilled nursing facility, a separate wing of a hospital, a nursing home, or a freestanding facility; to qualify for SNF coverage, Medicare requires a person to have been a hospital inpatient for at least three consecutive days (not including the day of discharge)

question

spell of an illness

answer

also known as the benefit period; the period of time that begins when a beneficiary enters the hospital and end 60 days after discharge from the hospital or from a SNF.

question

State Children's Health Insurance Program (SCHIP)

answer

a program for children whose parents have too much money to be eligible for Medicaid, but not enough to buy private insurance, it is jointly financed by the federal and state governments, and administered by the states.

question

statute of limitatioins

answer

the amount of time in which a claim must be collected before it is deemed paid or stisfied.

question

superbill

answer

an invoice used to document the services ordered or rendered during a patient visit; it is often referred to as a face sheet and includes patient demograpic data plus the CPT, ICD-9-CM, and HCPCS codes for the most common procedures performed in the practice or department; upon completion of treatment, the physician completes the superbill to document all services provided; thus a superbill essentially is a tool to eliminate the need for transcribing medical record notes from a patient chart and streamline the chare capture process

question

Title XVIII

answer

Medicare

question

Title XIX

answer

Medicaid.

question

TJC

answer

The Joint Commission; the organization that accredits hospitals; formerly called the Joint Commission on Accreditation of Healthcare Organizations (JCAHO); accreditation is extremely important for hospitals as it is a requirement of participation in the Medicare Program.

question

tort liability

answer

a liability for an injury or wrongdoing by one person to another resulting from a breach of legal duty.

question

TPA

answer

third party administrator

question

TRICARE

answer

a regionally-managed healthcare program for active duty and retired members of the uniformed services, their families, and survivors.

question

Truth in Lending Act

answer

another name for Title I of the Consumer Credit Protection Act; also known as Regulation Z; it requires disclosure of information before credit is extended.

question

UB-04

answer

the u niform bill requied of hospital inpatient and outpatient departments, skilled nursing facilities, home health practitioners, comprehensive outpatient rehabiliitation facilities, community mental health centers, and the like when billnig Medicare

question

UCR ( Usual, Customary, and reasonable)

answer

Usual, customary, and reasonable; a method to determine the value of services used by many third party payers; it relies on the physician charge data accumulated over time; after ranking the charges for a given service from lowest to highest, the payer uses a specific point, (for example, the 75th percentile) as the basis for UCR payments.

question

unintentional

answer

a type of skip in which someone moves or changes residence and fails to notify creditors; a forwarding address is normally available.

question

unproccessable

answer

a claim that is considered incomplete or invalid due to missing claim form data elements.

question

v code

answer

a type of ICD-9-CM code used when services or visits relate to circumstances otehr than disease or injury.

question

VA

answer

the U>S> Department of Veterans Affairs.

question

VCIS

answer

voice case information system; a telephonic system used to perform an on-site check at the bankruptcy clerk's office,.

question

workers' compensation

answer

a plan that covers injuries sustained by a worker in the course of performing his or her job duties.

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