1500
A claim submitted with errors or one that requires manual processing to resolve problems or is rejected for payment.
A nationwide health insurance program for people age 65 years of age and older and certain disabled or blind persons regardless of income?
Medicare
diagnosis
dx
4 times a day
q.i.d
What Appendix A in your CPT book?
Modifiers
An insurance claim submitted on paper, including those optically scanned and converted to an electronic form by the insurance carrier?
Paper Claim
An insurance plan issued to an individual (or his or her dependents); also known as individual contract?
personal insurance
medical decision making
MDM
immediately
stat
What is the universal billing form
CMS 1500
Insurance claim that has been canceled, deleted, or voided by a Medicare fiscal
deleted claim
Illnesses or injuries acquired by the patient before enrollment in an insurance plan?
preexisting conditions
twice daily
b.i.d
left eye
o.s.
What does CPT stand for?
Current Procedural Terminology
An insurance claim submitted to the insurance carrier via a central processing unit (CPU), tape, diskette, direct data entry, direct wire, dial-in telephone, digital fax, or personal computer download or upload?
electronic claim
The contract holder covered by an insurance program or managed care plan who either has coverage through his or her place of employment or has purchased coverage directly from the plan or affiliate.
Subscriber
Before Meals
a.c.
as needed
prn
When are CPT and ICD10 codes updated and used?
Updated November and used in January
any medicare claim missing necessary information; such claims are identified to the provider so that they may be resubmitted
incomplete claim
A requirement of some health insurance plans to obtain permission for a service or procedure before it is done and to see whether the insurance program agrees that it is medically necessary?
Pre-authorization
right eye
o.d.
disharge
dc
What does ICD10 stand for?
International Classification of Diseases 10th revision, clinical modification