Insurance week 2
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NPI
answer
Unique 10-digit identifier for covered health care providers
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CMS
answer
Centers for Medicare and Medicaid services
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EOB
answer
Document explaining payments made by the insurance company
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EDI
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Electronic system required for filing electronic claims to CMS
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ECT
answer
Method for monitoring the status and payment of insurance claims
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ASCA
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Specifies reasons a provider may submit paper claims
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EMC
answer
Electronic claims sent to CMS
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CMS-1500
answer
Standard claim form filed by providers office for reimbursement
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Electronic claims tracking is what?
answer
Most common way to monitor insurance claims today
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Explanation of benefits (EOB) is
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Received by the patient and shows what the insurance company has paid
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Clearing house is what?
answer
A company that provides a service between providers and payers, running a claims scrub on all claims to check for missing or invalid data
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Third-party reimbursement ?
answer
Phrase that was coined to indicate payment of services rendered by someone other than the patient
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What does a secondary insurance do?
answer
Will pay most if not all of the balance left over from the primary insurance to the provider
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What is electronic data interchange used for?
answer
Transactions allow a medical facility or a providers office to submit transactions faster and therefore be paid for claims faster
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Bookkeeping is for what?
answer
Recording financial transactions of a business
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What does electronic data interchange (EDI) do?
answer
Computer to computer exchange of medical information
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What are some federal health care programs?
answer
Champva, Indian health service, Medicare, Medicaid, tricare, works compensation
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An ambulatory surgical center (ASC) is
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State licensed, Medicare certified supplier of surgical care services that must accept assignment on Medicare claims
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Carrier is what?
answer
Insurance company providing coverage under a specific plan
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Daysheet is what?
answer
Form used for recording all daily financial transactions of charges made and payments received; also called a daily journal
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A ledger is what?
answer
Principal account book of a business establishment, containing the credits and debits; a record of all transactions for a given account
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Trial balance?
answer
Bookkeeping strategy to confirm the accuracy of debits and credits in a ledger
question
Posting means?
answer
Transferring information from one record to another; transferring charges from the Daysheet to the patient account records
question
NPI
answer
Unique 10-digit identifier for covered health care providers
question
CMS
answer
Centers for Medicare and Medicaid services
question
EOB
answer
Document explaining payments made by the insurance company
question
EDI
answer
Electronic system required for filing electronic claims to CMS
question
ECT
answer
Method for monitoring the status and payment of insurance claims
question
ASCA
answer
Specifies reasons a provider may submit paper claims
question
EMC
answer
Electronic claims sent to CMS
question
CMS-1500
answer
Standard claim form filed by providers office for reimbursement
question
Electronic claims tracking is what?
answer
Most common way to monitor insurance claims today
question
Explanation of benefits (EOB) is
answer
Received by the patient and shows what the insurance company has paid
question
Clearing house is what?
answer
A company that provides a service between providers and payers, running a claims scrub on all claims to check for missing or invalid data
question
Third-party reimbursement ?
answer
Phrase that was coined to indicate payment of services rendered by someone other than the patient
question
What does a secondary insurance do?
answer
Will pay most if not all of the balance left over from the primary insurance to the provider
question
What is electronic data interchange used for?
answer
Transactions allow a medical facility or a providers office to submit transactions faster and therefore be paid for claims faster
question
Bookkeeping is for what?
answer
Recording financial transactions of a business
question
What does electronic data interchange (EDI) do?
answer
Computer to computer exchange of medical information
question
What are some federal health care programs?
answer
Champva, Indian health service, Medicare, Medicaid, tricare, works compensation
question
An ambulatory surgical center (ASC) is
answer
State licensed, Medicare certified supplier of surgical care services that must accept assignment on Medicare claims
question
Carrier is what?
answer
Insurance company providing coverage under a specific plan
question
Daysheet is what?
answer
Form used for recording all daily financial transactions of charges made and payments received; also called a daily journal
question
A ledger is what?
answer
Principal account book of a business establishment, containing the credits and debits; a record of all transactions for a given account
question
Trial balance?
answer
Bookkeeping strategy to confirm the accuracy of debits and credits in a ledger
question
Posting means?
answer
Transferring information from one record to another; transferring charges from the Daysheet to the patient account records
question
Methods of billing are?
answer
Monthly billing, cycle billing and computerized billing
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Viability
answer
Capable of success or continuing effectiveness; practicable
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Alpha search
answer
Seeking a name by entering in a system the 1st few letters
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Expended
answer
Used up or spent
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PMS
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Practice management software
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Idle
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Harmless
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Skip
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Pt who has moved to avoid payment
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Truth in lending
answer
An act enforced by the FTC
