A state entitlement program that provides medical assistance for families and individuals with low income and resources.
What is Medicaid?
100
A claim that needs to be printed and sent by regular mail to the insurance carrier.
What is a paper claim?
100
An itemized bill that specifies the balance due on a patient's account.
What is a statement?
100
all demographic and insurance information on a patient is contained on this.
What is a registration form?
100
diagnoses most common to the medical practice are listed here.
What is Diagnoses list?
200
A.K.A. traditional or commercial insurance, this type of insurance gives patients the most choices with no restrictions on which doctors they can see, referrals are not required, and authorization is rarely needed.
What is an indemnity plan?
200
Three steps involved in ____ ______ ___________ ________ : claims preparation, claims editing, and claims submission.
What is The Claims Management Process?
200
A service that allows users to manage and pay bills online through a secure Web site.
What is a bill pay system?
200
provides 24-hour care to patients with the highest level of medical need (serious illness, surgery and recovery, accidents, observation)
What is a hospital?
200
also known as encounter form, charge ticket, visit slip, and voucher; contains all information insurance companies require in order to consider a claim for payment.
What is a superbill?
300
A system of health plans that attempts to control costs by limiting access to health care and focusing on preventative medicine.
What is Managed Care?
300
A unique, government issued identification number for individual health care providers.
What is National Provider Identifier (NPI)?
300
created when a patient seeks medical services from a physician.
What is a contract?
300
an entity that provides nursing care and rehabilitation services to the elderly with illnesses, injuries, or functional disabilities.
What is a nursing home?
300
identifies and matches a document to the services posted to the software.
What is a reference number?
400
The nation's first Blue Cross and Blue Shields programs originated in this state.
What is California?
400
9 points of specific information required for all claims submission.
What is requirements for insurance claims submission?
400
a billing technique that splits up a patient's account into smaller segments, which are billed at different times of the month.
What is cyclic billing?
400
for patients who need 24-hour nursing supervision in order to ensure their medical, psychological, or social needs are met.
What is a Skilled Nursing Facility (SNF)?
400
the location where services were rendered to the patient is indicated in this area.
What is Place of Service?
500
This was signed by President Obama on March 23, 2010 from the idea of a universal health system and medical care for all eligible people in the U.S.
What is The Patient Protection and Affordable Care Act (PPACA)?
500
The claim form approved by the Centers for Medicare & Medicaid Services, used by the Medicare program for submitting claims from physicians and suppliers, and is accepted by the majority of insurance carriers.
What is CMS-1500?
500
1.) payee information
2.) date of payment
3.) numeric dollar amount matches written-out amount
4.) signature of patient, or payer
5.) name and address of patient or the payer
6.) memo/notes line
What is the 6 necessary components of a check submitted for payment?
500
a facility where surgery, medical procedures, or skilled rehabilitation services are performed and patients leave the center to return home the same day.
What is an Ambulatory Surgical Center?
500
advises Medicare beneficiaries, before items or services actually are provided, when Medicare is likely to deny payment for them.