Test your basic knowledge |

Health Insurance

Subject : industries
Instructions:
  • Answer 50 questions in 15 minutes.
  • If you are not ready to take this test, you can study here.
  • Match each statement with the correct term.
  • Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. Form used to report institutional - facility services.






2. Determines coverage by primary and secondary policies when each parent subscribes to a different health insurance plan.






3. Series of fixed length records submitted to payers to bill for health care services.






4. Remittance advice submitted by Medicare to providers that includes payment information about a claim.






5. The insurance claim form used to report professional services






6. A computerized permanent record of all financial transactions between the patient and the practice;also called patient account record.






7. Remittance advice that is submitted to the provider electronically and contains the same information as a paper-based remittance advice; providers receive ERA more quickly.






8. A routing slip - charge slip - encounter form - or suberbill from which the insurance claim was generated.






9. The landmark legislation because it launched truth in lending disclosures that reguired creditors to communicate the cost of borrrowing money in a common language so that consumers could figure out the charges - compare cost - and shop for the best c






10. Prohibits discrimination on the basis of race - color - religion - national origin - sex - martial status - age - reciept of public assistance - or good faith exercise of any rights under the Cunsumer Credit protection ACT.






11. Sending data in a standardized machine readable format to an insurance company via disk - telephone or cable.






12. Also called a day sheet - a chronological summary of all transactions posted to individual patient ledgers/accounts on a specific day.






13. A computerized permanent record of all financial transactions between the patient and the pratice - also called patient ledger.






14. Does not contract with the insurance plan; patient who elects to recieve care from nonPARS will incur higher out-of-pocket expenses.






15. Series of fixed length records submitted to payers to bill for health care services.






16. Clearinghouses that involves value-added vedors - such as banks - in the processing of claims; using a VAN is more efficient and less expensive for providers than managing their own systems to send and receive transactions directly from nummerous ent






17. Establishes the rights. liabilites - and rsponsibilities of participants in electronic funds transfer systems.






18. A check made out to the patient and the provider.






19. Claims for which all processing - including appeals - has been completed.






20. Advances through various aging periods( 30 -60 -90 -120) with practices typically focusing internal recovery efforts on older delinquent accounts.






21. Health plans - healthcare clearinghouses - government health plans - and any health providers that choose to submit or receive transactions electronically.






22. A correctly completed standardized claim






23. The transmission of claims data (electronical or manually) to payers or clearinghouses for processing.






24. One that has not been paid within a certain time frame; also called delinquent account






25. Person responsible for paying healthcare fees






26. Also called manual daily accounts receivable journal; cronological summary of all transactions posted to individual patient legers/accounts on a specific day.






27. Accounts receivable that cannot be collected by the provider or a collect agency.






28. Specifies what a collection source may or may not do when pursuing payment on past due accounts.






29. Established by health insurance companies for a health insurance plan; usually has limits of $1000 or $2000; when the patient has reached the limit of an out-of-pocket payment (deductable) for the year - appropriate patient reimbursement to the provi






30. Organization that accredits clearinghouses






31. Submitting multiple CPT codes when one code could of been submitted.






32. Theperson eligible to receive healthcare benefits.






33. Submitted to the payer - but processing is not complete






34. Assigning lower-level codes then documented in the record.






35. Computer to computer data exchange between payer and provider






36. The provider receives reimbursement directly from the payer.






37. Contracts with a helath insurance plan and accepts whatever the plan pays for procedures or services performed.






38. Term used for the encounter form in the physicians's office.






39. The percentage the patient pays for covered services after the deductible has been met and the copayment has been paid.






40. Services that are provided to a patient without proper authorization or that are not covered by a current authorization.






41. Assists providers in the collection of appropriate reimbursement for services rendered; includes functions such as insurance verfication/eligibility and preauthorization of services






42. Legal action to recover a debt; usually a last resort for a medical practice.






43. Is a public or private entity that processes of facilitates the processing of nonstandard data elements into standard data elements.






44. Amended the Truth in Lending Act - requiring credit and charge card issuers to provide certain disclosures in direct mail - telephone - and any other application and solicitations for open-end credit and charge accounts and under other circumstances;






45. System by which payers deposit funds to the providers account electronically.






46. Associated with how an insurance plan is billed-the insurance plan responsible for paying healthcare insurance claims first is considered primary.






47. Financial record source document used by providers and other personnel to record treated diagnoses and services rendered to the patient during the current encounter.






48. The maximum amount a payer will reimburse for each procedure or service - according to the patient's policy.






49. A claim that is usually more than 120 days past due; some practices establish time frames that are less than 120 days.






50. Uses a variable-length file format to process transactions for institutional - professional - dental - and drug claims.







Sorry!:) No result found.

Can you answer 50 questions in 15 minutes?


Let me suggest you:

Browse all subjects

Browse all tests

Most popular tests



Major Subjects

Tests & Exams


AP
CLEP
DSST
GRE
SAT
GMAT

Browse all subjects

Browse all tests

Most popular tests