17.1
what other people can a health plan cover?
Spouse and children
What year did MACRA require CMS to provide new medicare cards without ssn.
2019
What are 3 patient information that you need to obtain?
Current employer
Employer address and telephone
Insurance
Patient signature on insurance release info form
Patients signature of assessment of benefit form
Medical healthcare claims are not only records, but a clear form of___
Communication
What is the name of the group that standardizes and formats medical billing documents for practices?
Clearhouse
Are dental and eye examinations always covered with insurance?
no
Is Medicaid an insurance program,
It is a cost assistance program.
What are 3 patient facts you need to verify?
Patient legal name
Current home address
Current telephone number
Before the claims are processed, they must be “clean” -free from:
errors
What does DDE stand for?
Direct Data Entry
What is the healthcare that Obama made called and what is it for?
Answer:Name: Obama care.Insurance coverage to all americans.
What does CHAMPVA stand for.
Civilian Health and Medical program of the Veterans Administration
What is the first thing the medical assistant needs to do to make sure a patient is eligible for service?
Verify patients personal insurance info
The term given to the insurance when they are willing to finance a claim within a set amount of days ;ex: 60-90 days.
Date of Service
Give an example of something HIPAA requires for practice security:
Access control
Passwords
Logs for safekeeping
Backups
Security policies to handle violations
What are the two major types of health plans?
What are the two major types of health plans?
What is the 3 step payment method.
Allowed Charges, Contracted fee schedule, capitation. Allowed charges, The maximum amount of payers will pay.
What are the 2 ways to obtain prior authorization?
Website
Phone
The __####__ claim set new standards that regulate the electronic transmission of specific health care transactions.
5010 claim
What do insurers check to justify treatment?
Benefits
Who does disability insurance cover?
Answer:Covers people who are injured or disabled for non work reasons.
What is workers com used for.
This is for people hurt on the job
What is one thing that the medical assistant needs to do when they receive the super bill?
Prepare and transmit a healthcare claim to the insurance company in behalf of patient
Accept payment from the patient for the full amount and the patient can submit a claim to the insurance carrier for reimbursement.
Accept insurance copayment and coinsurance from patients.
What are the 3 main pieces of Payment Advice?
RA - remittance advice
EOP - explanation of payment
EOB - explanation of benefits