This is the claim form used for outpatient facilities.
What is CMS-1500
100
These are behaviors that define the character or personality of an individual.
What are Personal Qualifications
100
This is a legal contract that provides money to cover all or a portion of the cost of medically necessary care.
What is Health Insurance.
100
A person who is being seen by a physician for the first time or a person who has not received services within the past 3 years
What is a new patient
100
CPC
What is a Certified Professional Coder
200
This is the claim form used by inpatient facilities.
What is UB-04 (or CMS-1450)
200
This is the process of documenting medical information as numeric codes.
What is Medical Coding.
200
Federal health insurance program for people aged 65 or older and retired on Social security, railroad retirees, federal government retirees, individuals legally disabled for 24 months, and person with end-stage renal disease.
What is Medicare.
200
The specified amount of money that the insured must pay for covered medical expenses before the insurance policy begins to pay.
What is a deductible.
200
CEU
What is a continuing education unit
300
This form contains patient demographics and billing information.
What is the Patient Registration Form.
300
Certification offered by the American Academy of Professional Coders and obtaining this is your ultimate goal.
What is CPC certification
300
This is the primary objective of managed health care programs.
What is to control health care costs.
300
A legal document requesting an individual to bring records to court
What is a subpoena duces tecum
300
PHI
What is protected health information
400
This form contains preprinted procedure and diagnostic codes use most frequently.
What is the Encounter Form.
400
Your certification is provided by this entity.
American Academy of Professional Coders
400
A managed care prepaid group practice that provides a specific range of inpatient and ambulatory health care services to its members.
What is a HMO (Health Maintenance Organization)
400
Permission granted by the insured that allows the insurance company to send payments directly to the physician, health care provider, hospital, or nursing facility.
What is assignment of benefits
400
COB
What is coordination of benefits
500
This form is filled out by Medicare beneficiaries and states they accept responsibility for charges when Medicare denies payment.
Advanced Beneficiary Notice
500
This insurance billing position is responsible for reviewing insurance forms to identify patterns of errors that result in unpaid or rejected claims; monitoring medical coding accuracy, and maintains knowledge of regulations related to insurance collection practices.
What is an Insurance Collection Specialist
500
This reimbursement method reimburses providers for each individual service.
What is Fee for Service
500
a set fee per month per enrolled member, regardless of the number of patient visits or frequency of services provided.
What is Capitation.
500
HIPAA
What is Health Insurance Portability and Accountability Act of 1996