Medical Terminology
Medical Abbreviations
Benefits
Pends
Training
100
Tripsy
What is "to crush" Example - lithotripsy for eliminating a stone in the pelvis, ureter, bladder or gall bladder.
100
OTC
What is "over the counter".
100
Limit for spinal manipulation and accupunture
What is "60 visits per calendar year".
100
What is a status code for a PBH encounter claims
What is "81"
100
What does FCHN stand for?
What is "First Choice Health Network".
200
Cilia
What is "eyelashes" (tiny hair like structures)
200
SOB
What is "shortness of breath"
200
Define "common deductible"
What is "a deductible that accumulates both in and out of network copay and coinsurance"
200
what is the EMEM pend?
What is "eligibility not found"
200
What does the TC modifier stand for? and please define it.
What is "Technical Component" "it is the act of taking an xray".
300
Tomy
What is "cutting, incising, incision".
300
PTSD
What is "post traumatic stress disorder"
300
Define "combined deductible".
What is "a deductible that applied to medical and pharmacy benefits".
300
True or false. You should never reprocess a claim where a partial refund has been received.
What is "false - you can reprocess a claim until it is zeroed out by OFT".
300
Can you name the new PHS group that we will be implementing 2015.
What is "Swedish Hospital"
400
Ante
What is "What is "describing something as positioned in front of another thing"
400
IUD
What is "intrauterine device".
400
What is the copay for the ER room?
What is "$100 copay, after in-plan deductible".
400
Correction question...One claim went to the deductible, and 2 denied as dupes more recently. Which claim do you reprocess?
What is "the claim that applied to the deductible.
400
Can you name 6 of the 13 steps of adjudication?
What is "Eligibility, Provider, Service Definition, Charge Roll-up, Duplicate Editing, Managed Care Edits, Clinical Editing, Line Item Prefixes, Pricing, Service Rules, COB, Accumulators, Processing Control Agent.
500
Ambi
What is "both or both sides" Example - ambidextrous
500
COPD
What is "chronic obstructive pulmonary disease".
500
What does OOP max stand for?
What is "out of pocket maximum".
500
Correction states charges were billed in error. The original claim applied to deductible, paying $0. Do you reprocess the original and zero out the charges?
What is "No you never zero out charges - you will reprocess the original zeroing out the allowable and use explanation code 003 and EOB code YPE to take away from the deductible".
500
Can you name the 6 items listed as part of our Halloween Raffle?
What is "family portrait, creepy candles, deaths door whiskey, 19 crimes wine, bloody goblet, plate/ bowl with chocolates.
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