Cookies
Cake
Pie
Ice Cream
Donuts
100
the amounts a provider bills for the services performed
What are Charges?
100
a certain length of time in which the expected services are to be provided—for each package
What is a Global Period?
100
A CPT modifier is composed of this many digits
What is TWO?
100
This indicates where services were performed
What is a POS code?
100
This specifies the number of days after the date of service that the practice has to file the claim.
What is a Payer's timely filing requirements?
200
Adjustments
What are changes to patients’ accounts
200
a group of related procedures and/or services included under a single code
What is a Package?
200
reporting items or services that are not documented but are usually part of a service
What is Assumptive Coding?
200
diagnosis, payments, and procedures can all be found in this document that is given to the patient
What is a Walk-out receipt?
200
The “official” name for the HIPAA standard transaction for electronic claims
What is the HIPAA X12 837 Health Care Claim
300
Payments
What are monies received from patients and insurance carriers?
300
This will happen if a Biopsy of the prostate is reported on a 57 year old female
Why will The claim be rejected?
300
charges for self-pay patients noncovered or overlimit fees copayments or coinsurance
What types of charges are collected at Time of Service?
300
If patient education materials to be given to the patient, these items are provided during this time period
What is Check-out?
300
This cannot easily be read because it prints out in a computer format that removes blank spaces.
What is A printout of a HIPAA claim?
400
This controls improper coding that would lead to inappropriate payment for Medicare claims
What is CCI - Correct Coding Initiative?
400
These can result from incorrect code selection or billing practices
What is Compliance errors?
400
Patients who do not have insurance coverage are called this
What is self pay patients?
400
diagnosis, charges, and procedures are all communicated to the payer via this document
What is a Claim?
400
This group determines the content of both the HIPAA 837 and the CMS-1500
What is the National Uniform Claim Committee (NUCC)
500
CPT codes are updated annually by this organization
What is the American Medical Association?
500
the CPT and ICD codes for a visit are appropriately related and demonstrate medical necessity
What is Code Linkage?
500
after an encounter is coded but before the claim is transmitted
When is a claim scrubber used?
500
A patient's eligibility for benefits and financial responsibility ban be determined immediately by doing this
What is Real Time Claim Adjudication?
500
The smallest units of information in a transaction
What are Data Elements?
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