Medical Terminology
Which of the following answers is an example of an eponym?
a. Alzheimer disease
b. cardiology
c. irritable bowel syndrome
d. magnetic resonance imaging
a. Alzheimer disease
PMHX is an abbreviation or the:
a. Personal medical history
b. Provider’s medical history
c. Patient’s past medical history
d. Practice management history
c. Patient’s past medical history
If a retired patient with Medicare also has coverage under a working spouse's plan, the primary plan is:
a. Medicare
b. the plan in effect for the longest
c. the plan with the lowest premium
d. the spouse's plan
d. the spouse's plan
Which of the following codes could be used to indicate that a procedure took place in a medical office?
a. administrative codes
b. taxonomy codes
c. place of service codes
d. diagnosis codes
c. place of service codes
The patient’s health plan has a $150 annual deductible. At the first visit of the year, the charges are $100. What does the patient owe?
$100
One who studies blood.
e. Hematologist
f. Vampire
g. Cardiologist
h. Dentist
e. Hematologist
Another term for the insured is:
a. subscriber
b. established patient
c. new patient
d. Parent
a. subscriber
Under what rule is a child's primary coverage determined based upon which parent's day of birth is earlier in the calendar year?
a. birthday rule
b. gender rule
c. parent rule
d. custody rule
a. birthday rule
Unlike an HMO, a PPO permits its members to use _________________________ providers, but at a higher cost.
out-of-network
What is the most commonly accepted and used term for storing and accessing patient healthcare information electronically.
EHR
Which of the following is NOT a medically necessary procedure?
a. Cosmetic nasal surgery
b. Nasal obstruction removal
c. Acquired facial deformity surgery
a. Cosmetic nasal surgery
What do payers issue when they approve a service?
a. prior authorization number
b. referral waiver
c. trace number
d. Self-referral
a. prior authorization number
After one health plan has paid on a claim, which insurance makes the next payment, if applicable?
a. disability insurance
b. primary insurance
c. secondary insurance
d. tertiary insurance
c. secondary insurance
______________ refers to a coding problem in which a procedure code is used that provides a higher reimbursement than the correct code.
Upcoding
______________ is an amount that an insured person pays at the time of a visit to a provider.
copayment
What is another term for contractual adjustment?
Write off
Which of the following type of plan do employers or employee organizations offer to their employees?
a. group health plan
What provision explains how insurance policies will pay if more than one policy applies?
c. coordination of benefits
_______ is a normal fee charged by a provider.
Usual fee
If a provider chooses not to participate in TRICARE, they may charge no more than _______ percent of the allowable charge.
b. 115
If a patient was sent by another physician, that physician is known as the
a. referring physician.
__________________ is the percentage of each claim that an insured person must pay.
coinsurance
The term ________ refers to using a single payment for two or more related procedure codes.
a. bundling
_______________ is the international standard diagnostic classification for all medical date concerning the incidence and prevalence of disease in large populations and for other health management purposes.
ICD codes
A patient’s insurance policy states: Annual deductible: $400.00 Coinsurance: 75/25
This year the patient has made payments totaling $399.00. Today the patient has an office (fee: $101). The patient present cash for payment of today’s bill. What is the amount that the patient should pay?
Fee $101.00- 1.00 (deductible bal)= $ 100.00 x .25 = $ 25.00
Patient will pay $26.00