Billing
the amount you pay out of pocket for covered health care services before your insurance plan starts paying
Deductible
Patients are scheduled at the same time, often on the hour, and are seen in order of arrival. Late patients don't disrupt the schedule.
Wave Booking
Sealed or unsealed typed or handwritten material, including letters, postal cards, postcards, and business reply mail.
First-class mail
This manual is used to code diagnoses and other health problems. It provides a standardized classification system for diseases, injuries, signs, symptoms, and other health conditions.
ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification):
included denials, billed amount, allowed amount, covered services, and patient financial responsibilities of deductible and coinsurance. A record of a patient's fees.
Explanation of Benefits (EOB)
fee collected at the time of service
Copayment
Each patient is given a specific appointment time based on their needs.
Stream Scheduling
First-class mail that weighs more than 13 ounces
Priority mail
This manual is used for coding procedures performed in inpatient hospital settings. It uses a seven-character alphanumeric code system to describe medical procedures.
ICD-10-PCS (International Classification of Diseases, 10th Revision, Procedure Coding System)
authorizes the provide to bill and receive payment for services
Assignment of Benefits
percentage of the healthcare costs the patient is responsible for after the deductible has been met.
Coinsurance
Patients are given a time frame in which they can arrive for their appointment.
Time-Slot Scheduling
Mail that includes advertising, promotional, directory, or editorial material, or any combination of such material.
Standard mail
This manual is published by the American Medical Association and is used for coding services provided by physicians and other healthcare professionals. It uses numeric codes.
CPT (Current Procedural Terminology):
used when tests, procedures, or services may not be covered by Medicare and the patient must sign the form after they are informed of this and agree to be financially responsibility in the event it is not covered.
Advanced Beneficary Notice (ABN)
In medical administration, which of the following documents is critical for ensuring the reimbursement of healthcare services provided to patients?
Superbills
(Critical for charge capture)
Patients are seen on a first-come, first-served basis.
Open Hours
Mail that has insurance coverage against loss or damage.
Insured mail
This code set is used for coding services and supplies not covered by CPT codes, such as durable medical equipment, ambulance services, and certain medications. It uses alphanumeric codes.
HCPCS Level II (Healthcare Common Procedure Coding System)
The order of which multiple plans pay for medical services
Coordination of Benefits (COB)
In a medical billing context, what is the set amount a patient pays each month for health insurance coverage?
Premium
Similar to wave booking, but with open slots later in the hour to accommodate late arrivals.
Modified Wave
Mail of all classes protected by registering and requesting evidence of its delivery.
Registered mail
First-class mail that also gives the mail added protection by offering insurance, tracking, and return receipt options.
Certified mail
the amount you pay out of pocket for covered health care services before your insurance plan starts paying
Deductible