Medical Terminology
This prefix means “slow.”
What is brady–?
The first step when a patient arrives at the clinic or hospital.
What is check-in?
This is the first step in the denial management process, where the reason for the denial is identified.
What is denial analysis?
This organization publishes the CPT manual
What is the American Medical Association (AMA)
This is the form submitted to insurance to request payment for medical services.
What is a claim?
The term "hepato-"refers to what?
What is the Liver?
This federal law protects patient health information
What is HIPAA?
This type of denial occurs when the insurance company believes the service provided was not medically necessary.
What is a medical necessity denial?
I10 is the ICD-10-CM code for this cardiovascular condition.
What is essential (primary) hypertension?
This government program provides health coverage to people 65 and older or with certain disabilities.
What is Medicare?
This word root refers to the stomach
What is gastr/o?
These documents are often required to confirm a patient's identity and insurance information during registration
What is a photo ID and insurance card?
This type of denial happens when the claim is submitted after the insurance company's deadline.
What is a timely filing denial?
Modifier -25 is used when this occurs on the same day as a procedure.
What is a significant, separately identifiable E/M service?
This term refers to the approval from an insurance company before a patient can receive certain medical services.
What is prior authorization?
The skin, hair, and nails make up this system
What is the integumentary system?
A patient returning within 3 years for a visit is considered this.
What is an established patient?
This term refers to the process of correcting and resubmitting a denied claim to the insurance company.
What is claim resubmission?
This placeholder character is used when a code requires a 7th character but lacks 6 preceding digits.
What is 'X'?
This document explains how a medical claim was processed and what the patient may owe.
What is an Explanation of Benefits (EOB)?
This suffix means “surgical removal.”
What is –ectomy?
When a patient has two insurance plans, this determines which one pays first.
What is coordination of benefits?
This is the process of ensuring that all necessary documentation is included with the claim to prevent denials.
What is documentation review?
The "CM" in ICD-10-CM stands for this.
What is Clinical Modification?
This term refers to the maximum amount an insurance company will pay for a covered service.
What is the allowable amount?