Jargon
If you go to specialty appointment and are asked to pay $20 before the visit, you are paying this.
What is a copay?
This part of Medicare insurance covers hospitalizations and skilled nursing facility stays
What is Medicare part A?
This is an example of a CPT code.
Procedure code -
If you're getting an MRI and they tell you that you will have to pay 10% of the cost, you a paying this.
What is co-insurance?
This part of Medicare insurance pays for physician visits and durable medical equipment
What is Medicare part B?
The most commonly billed CPT code is an E&M code, which stands for
What is evaluation and management?
If a patient has a high deductible plan, they how does this change their copay and coinsurance?
They have to pay the total cost, not a copy or co-insurance
This is another name for Medicare Advantage
What is Medicare part C?
These are the CPT codes that you still need to precept for Medicare and Medicaid patients?
What are level 4 and level 5 visits?
Commercial patients usually have HMO or PPO insurance, which stands for this.
What is Health Maintenance Organization or Preferred Provider Organization?
What is Medicare part D?
True/false: when you are billing for a procedure, there isn't a CPT code.
What is false?
True/false - once a medication is approved by the FDA, it has to be covered by prescription drug insurance.
What is false?
(What do you say to patients when they ask about this?)
These vaccines are covered by prescription coverage so may not be fully covered even if medical indicated.
What is hep A, TdaP, Shingrix, RSV?
(basically everything except flu, Covid - for now, PCV, hep B)
True/false - a MCR code is the same as a CPT code?
What is false?