Language of Medical Billing
What does medical billing seek to achieve?
Medical billing seeks to achieve financial reimbursement for healthcare services or supplies rendered.
What is a billing cycle?
A billing cycle is the time it takes to submit a claim and process reimbursement or payment.
What is the purpose of the maximum out-of-pocket cost?
The purpose of the maximum out-of-pocket cost is to limit the amount a patient pays before insurance covers the remainder of the bills.
What is medical transcription and coding?
Medical transcription and coding involve converting physician notes into a transcript with medical codes.
What constitutes a billing error?
Typographical errors, coding mistakes, or incorrect information submitted.
What is the role of medical assistants in the billing process?
Medical assistants play a key role in the medical billing process, including receiving and recording payments and completing billing.
How are CPT codes maintained?
CPT codes are maintained by the American Medical Association (AMA).
What does HIPAA stand for?
HIPAA stands for Health Insurance Portability and Accountability Act.
In the billing cycle, what is meant by the starting and stopping time?
In the billing cycle, the starting and stopping time refers to the period from claim submission to payment due date.
What must be corrected if a bill is sent to the wrong person?
If a bill is sent to the wrong person, the healthcare facility is responsible for correcting the medical billing error.
What does the acronym ICD stand for?
International Classification of Diseases
What are billing codes used for?
Billing codes are used to specify the service or procedure performed to treat the health concern.
What is a co-pay?
A co-pay is the fixed amount of money a patient owes for a medical visit.
What step follows the patient-provider encounter?
The step that follows the patient-provider encounter is medical transcription and coding.
What might happen if a billing error is made?
If a billing error is made, it may lead to the amount incorrectly billed being incurred by the hospital or medical facility.
What is a diagnosis code?
A diagnosis code describes the patient’s medical condition or disease.
What does CPT stand for?
Current Procedural Terminology
What is a deductible?
A deductible is the amount of money a patient must pay before insurance will cover an expense.
What is one reason for insurance verification?
One reason for insurance verification is to ensure the patient's insurance is valid and applicable for the procedure.
What is a common reason a medical claim may be denied?
A common reason a medical claim may be denied is due to typographical or coding errors.
What term describes the fixed amount a patient pays for a medical visit?
Co-pay
What is the importance of accuracy in billing codes?
Accuracy is essential for claims submitted to insurance and other third-party payers.
What is the maximum out-of-pocket limit for an individual in 2023?
The maximum out-of-pocket limit for an individual in 2023 is $9,100.
What is the first step in the billing process after patient treatment?
The first step in the billing process after patient treatment is to register the patient in the system.
What should medical claim forms include?
Medical claim forms should include diagnosis, treatment, medication, and other services.