CLAIM IT
THE 837P has how many sections?
5
the ___-to___ ___________ is the organization or person that receives payment
pay to provider
the insured's ID number is also known as the_________________________________.
identification number of the policy holder
HIPAA 837 is set up as a hierarchy. why?
so data is not repeated, starts with provider at the top
which Act is a law that requires disclosure of finance charges and late fees for payment plans?
Truth in Lending Act
what is sent as additional data to support a claim?
attachment
what type of managed care program does BCBS offer ?
HMO, POS and PPO
if a patient was sent by another physician, the physician is known as the _________physician
referring
the condition code _____ is used for an abortion due to social or economic reasons.
AG
a good financial policy is clear to whom?
both patients and the practice staff
concept of equality with medical/surgical benefits
parity
which section of a managed care participation contract covers protection against loss?
managed care plan obligations sections
the POS code used to indicate a procedure occurred in a skilled nursing facility. POS CODE __________
31
the ____________ report is the start of the process of collecting payments due from patients
patient aging
name the electronic format that practices us to ask payers about claims?
* HINT IT STARTS WITH HIPAA THEN consist of letters/numbers
HIPAA X12 276/277
what test may help a practice determine if a patient has the ability to pay for medical services?
means test
who may be covered under a GHP? name 3
employees, families and former employees
FDCPA is the abbreviation for :
the job of creating and implementing the practice's collections policies is done by ______________ (which job title)
the billing/ collections manager
who is responsible for regulation the hours during which collection calls may be made?
both the FDCPA and the Telephone Consumer Protection Act