Admitting & Registration
Who is the person that is ultimately responsible for paying the patient's bill?
Who is the Guarantor
What is the Medicare Part A deductible?
What is $1068?
What is Payor Authorization?
What is approval from third party payors to provide specified care in a particular setting; written or electronic assurance that the services provided will be covered under the terms of the patient’s health care plan?
What is a Deductible?
What is a fixed sum that a beneficiary must contribute towards the cost of their health care before insurance benefits begin?
What is the
Health Insurance Portability and Accountability Act?
What is HIPAA?
Who is the Attending Physician?
Who is the physician who supervises a patient’s care during an inpatient stay.
What is Patient Liability?
What is the dollar amount that an insured is legally obligated to pay for services by a provider?
The process to obtain approval for a specific service to be provided to a patient.
What is a Pre-Certification?
Who is the subscriber?
Who is the individual who carries the insurance coverage?
What is the
Emergency Medical Treatment and Active Labor Act?
What is EMTALA?
When an insurance company does not have a contract with a facility.
What is What is Out of Network?
What is Verification of Benefits?
What is validating with third party payors that a given plan is active and ascertaining the patient’s deductible, co-pay and limitations?
This is required prior to obtaining an authorization for an HMO plan.
What is a PCP Referral?
What is a co-pay?
What is a fixed amount the beneficiary pays for health care services, regardless of the actual charge; the amount is designated as the patient’s responsibility.
What is the
Joint Commission on Accreditation of Health Care Organizations?
What is JCAHCO?
What is Out Patient Care?
What is treatment received by a patient in a hospital or clinic. The patient does not require hospitalization?
When an insurance company refuses to pay a claim we have submitted to them.
What is a Denial?
What is the purpose of the
Advance Beneficiary Notice?
What is to inform the patient that Medicare may not consider the health services being provided as medically necessary and that there is a good possibility that Medicare will not pay for the service provided and the patient may be billed for the service?
Who is an Oncologist?
Who is a physician who specializes in the diagnosis and treatment of cancer?
What is the
Important Message from Medicare?
What is IMM?
This is the place where coverage is applied and charges & documentation are captured for a particular visit.
What is the Hospital Account Record (HAR)?
The process of identifying which insurance should be billed first for patients with multiple insurances.
What is Coordination of Benefits?
This form is used to notify a patient that their insurance may not pay for a particular service.
What is an Insurance Waiver.?
What is identity theft?
What is fraud committed or attempted using identifying information of another person without authority?
What is the
Advance Beneficiary Notice?
What is ABN?