ROLES & RESPONSIBILITIES
GENERAL
TYPE OF INSURANCE
HISTORY
DEFINITIONS
100
A basic skill requirement
What is Medical Terminology?
100
Documentation submitted requesting reimbursement of services provided
What is health insurance claim
100
Identification+treatment of disease
What is Medical care
100
The concept of physician specialists came during this period
What is 1900-1940
100
Allows complete freedom in the choice of health care providers
What is Fee-for-service plan
200
Rules that govern the conduct of members of a profession.
What is ethics
200
Prior approval for treatment
What is preauthorization
200
Medical care+preventative services
What is Health care
200
Employers began to offer employer-sponsored medical or health insurance as an incentive
What is during WWII
200
The amount a patient pays monthly, quarterly or yearly that keeps them enrolled in a plan
What is a premium
300
Basic understanding of how the body functions?
What is Basic Anatomy & Physiology?
300
A physician or other health care practitioner
What is health care provider
300
A contract between a policy holder and insurance carrier or government program
What is health insurance
300
The World Health Organization developed the International Classification of Disease
What is 1948
300
A specified amount of annual out of pocket expenses for covered health care services
What is deductible
400
Skill that are necessary in dealing with both patients and insurance companies.
What is communication skills
400
Administrative agency within federal Department of Health and Human Services (DHHS)
What is Health Care Financing Administration (HCFA)
400
Reimbursement for income lost as a result of a temporary or permanent illness or injury
What is disability insurance
400
Developed a procedural coding system to standardize procedural terminolgy
What is American Medical Association
400
A 10-digit identification number that is assigned to providers
What is National Provider Identifier (NPI)
500
Comfortable with the use of computerized equipment
What is data entry ability
500
The process of reporting diagnoses, procedures, and services
What is coding
500
Policy that covers losses to a third party caused by the insured
What is liability insurance
500
Originally designed to cover individuals 65 and older
What is Medicare
500
A uniform language for the electronic transmission of health information
What is Electronic transaction standards
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