A request for review of an insurance claim that has been underpaid
What is an appeal
200
The job title abbreviated as ALJ
What is an Administrative Law Judge
200
It's what CMS stands for
What is the Center for Medicare and Medicaid Services
200
This suffix means "seizure"
What is -lepsy
400
This prefix means "around"
What is circum-
400
Don't giggle - this tool is used in your office to track pending or resubmitted claims
What is a tickler
400
It's known as the FTC
What is the Federal Trade Commission
400
It's Medicare's first level of appeal
What is redetermination
400
This suffix means "to burst forth"
What is -rrhage
600
This prefix means "many, much"
What is poly-
600
A report you run that tells you which claims are outstanding by how old they are, aka over 30, over 60, over 90, over 120 (call Ms. De Fiesta's company)
What is an aging report
600
You call this office when your insurance company is behaving badly (ignoring claims, making payments too late)
What is the State Commissioner
600
This notice is signed in advance by a Medicare beneficary indicating that a service is not covered
What is an Advance Beneficiary Notice
600
This suffix means "condition of pain"
What is algesia-
800
This prefix means "upper, above"
What is super-
800
A review of a patient's case by one or more physicians to evaluate another physician
What is peer review
800
DAB is not a dance move; it's an acronym
What is Departmental Appeal Board
800
A supplemental insurance for Medicare patients that may cover deductibles and copayments
What is Medigap
800
This suffix means "surgical excision"
What is -ectomy
1000
The prefix for "both, both sides"
What is ambi-
1000
Claim that is held in a pended state because of an error or need for more information