REVENUE CYCLE CHAPTER 13
The 1st step in the claims adjudication process.
What is the initial process?
Medical term that means "procedure to measure oxygen levels."
What is oximetry?
The common abbreviation for a pap smear.
What is PAP?
To double-check that totals are accurate and consistent.
What is to do reconciliation?
A patient or provider who appeals a claim.
Who is a claimant?
Service provided to a patient on the same date at the same place of service by two or more physicians.
What is Concurrent care?
Air and blood in the chest.
What is a Pneumohemothorax
An appointment scheduling system that groups similar appointments together during the day or week.
What is Cluster scheduling. ?
The payer is paying a different amount than the amount billed.
What is an Adjustment?
A procedure a payer determines was not medically necessary at the level reported.
What is downcode?
The process of determining whether to pay, reject, deny or partially pay claims.
What is adjudication?
Lung disorder caused by the limiting of air into the lungs.
What is a restrictive lung disorder.
When two or more patients are scheduled for the same appointment time
What is double-booking?
What is acknowledgment that the claim has been received.
What is an "A" claim code?
They follow up on claims that are not processed within the specified claim turnaround time for the payer.
Who are Medical Insurance Specialist?
The claim status when the payer is developing the claim.
What is suspended?
A lung removal.
What is a Pneumonectomy?
Establish the matrix of the appointment book.
What is the first step in preparing the appointment book?
Code a claim is pending?
What is claim "P"?
A feature of some medical billing programs that automatically records payments in the correct accounts.
What is autoposting?
The number of steps in the Medicare appeals process.
What is five?
"Involuntary contraction of the diaphragm" (also known as the hiccups).
What is phrenospasm?
An appointment scheduling systems allows patients to arrive at their own convenience with the understanding that they will be seen on a first-come, first-served basis?
What is open-hours scheduling?
MRN
What is Medicare Redetermination Notice?
A medical practice may choose to _______ a rejected or partially paid claim.
What is appeal or resubmit?