In The Beginning
The Claim Game
Legal Eagle
Take Your MEDI-cine
The End
100
This prefix means "within"
What is intra-
100

A request for review of an insurance claim that has been underpaid

What is an appeal

100
The job title abbreviated as ALJ
What is an Administrative Law Judge
100
It's what CMS stands for
What is the Center for Medicare and Medicaid Services
100
This suffix means "seizure"
What is -lepsy
200
This prefix means "around"
What is circum-
200
Don't giggle - this tool is used in your office to track pending or resubmitted claims
What is a tickler
200
It's known as the FTC
What is the Federal Trade Commission
200
It's Medicare's first level of appeal
What is redetermination
200
This suffix means "to burst forth"
What is -rrhage
300
This prefix means "many, much"
What is poly-
300
A report you run that tells you which claims are outstanding by how old they are, aka over 30, over 60, over 90, over 120 (call Ms. De Fiesta's company)
What is an aging report
300

You call this office when your insurance company is behaving badly (ignoring claims, making payments too late)

What is the State Commissioner

300
This notice is signed in advance by a Medicare beneficary indicating that a service is not covered
What is an Advance Beneficiary Notice
300
This suffix means "condition of pain"
What is algesia-
400
This prefix means "upper, above"
What is super-
400

A review of a patient's case by one or more physicians to evaluate another physician

What is peer review

400
DAB is not a dance move; it's an acronym
What is Departmental Appeal Board
400
A supplemental insurance for Medicare patients that may cover deductibles and copayments
What is Medigap
400
This suffix means "surgical excision"
What is -ectomy
500
The prefix for "both, both sides"
What is ambi-
500

Claim that is held in a pended state because of an error or need for more information

What is a suspended claim

500
It's a common HIPPA error.
What is the misspelling of HIPAA
500
What we call Medicaid in California
Medi-CAL
500
This suffix means "formation, produce"
What is -genesis
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