SUBJECTS
|
BROWSE
|
CAREER CENTER
|
POPULAR
|
JOIN
|
LOGIN
Business Skills
|
Soft Skills
|
Basic Literacy
|
Certifications
About
|
Help
|
Privacy
|
Terms
|
Email
Search
Test your basic knowledge |
Medical Coding And Billing Clinical Vocab
Start Test
Study First
Subject
:
medical-transcription
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. A physician who specializes in a specific area of medicine - such as cardiology - oncology - urology
complience
phantom billing
Specialist
deductible
2. A process of meeting regulations - recommendations - and expectations of federal and state agencies that pay for health care services and regulate the industry
complience
ids
nonprivileged information
Participating Provider
3. An insurance plan requirement in which you or your primary care physician need to notify your insurance company in advance about certain medical procedures in order for those procedures to be considered a covered expense
referring physician
Preauthorization
(COB) Coordination of Benefits
Supplementary Medical Insurance
4. A health care plan that stipulates that the patient must use a medical provider who is under contract with the insurer for an agreed on fee
complience plan
closed panel HMO
(ABN) Advance Beneficiary Notice
ppo
5. Authorization given by a health plan for a Member to obtain services form a healthcare provider - most commonly required for hospital services
(POS) Point-of Service Plan
Pre-certification
Privileged information
(DRG's)
6. A health care provider that is not employed by the HMO and does not belong to a medical group owned or managed by the HMO
Open Enrollment
open panel HMO
preauthorization
business associate
7. A physician who is part of am managed care plan that provides all primary health care services to members of the plan
Medigap Insurance
pcp
breach of confidential communication
referring physician
8. Also known as out-of-network provider. A healthcare provider who has not contracted with the carrier of a health plan to be a participating provider of healthcare
Out of Network (OON)
Supplementary Medical Insurance
referring physician
(Non-par) Non-Participating Provider
9. Data related to the treatment and progress of the patient that can be released only when written authorization of the patient or guardian is obtained.
(PAC) Pre- Admission Certification
econdary Payer
(UCR) Usual - Customary and Reasonable
Privileged information
10. Incidents or practices - not usually considered fraudulent - that are inconsistent with accepted sound medical business or fiscal practices.
abuse
(APC) Ambulatory Patient Classifications
(EPO) Exclusive Provider Organization
Pre-certification
11. Managed care product that offers enrollees a choice among options when they need medical services - rather than when they enroll in the plan. Enrollees may use providers outside the managed care network - but usually at higher cost
(POS) Point-of Service Plan
(PCN) Primary Care Network
(TPA) Third Party Administrator
Participating Provider
12. Prior approval from a health care plan administrator to receive reimbursement for surgery and other procedures to be performed
referring physician
electronic media
preauthorization
business associate
13. Verbal or written agreement that gives approval to some action - situation - or statement.
consent
ee schedule
nonprivileged information
privacy
14. A group of physicians or other health care providers who have a contractual agreement to provide services to subscribers on a negotiated fee-for-services or capitated basis
cash flow
etiquette
Medigap Insurance
prepaid plan
15. A willful act by an employee of taking possession of an employer's money
Beneficiary
(PEC) Pre-existing condition
Embezzlement
closed panel HMO
16. Incidents or practices - not usually considered fraudulent - that are inconsistent with accepted sound medical business or fiscal practices.
Network
Deductible
abuse
(UCR) Usual - Customary and Reasonable
17. A management plan composed of policies and procedures to accomplish uniformity - consistency - and conformity in medical record keeping that fulfills offical requirements.
hmo
(TPA) Third Party Administrator
claim
complience plan
18. Medical staff member who is legally responsible for the care and treatment given to a patient.
clearinghouse
(Non-par) Non-Participating Provider
attending physician
Assignment & Authorization
19. A nonprofit integrated delivery system
(PPS) Hospital Impatient Prospective Payment System
(COB) Coordination of Benefits
security officer
medical foundation
20. American Medical Association
(TPA) Third Party Administrator
AMA
Pre-existing Condition Exclusion
pcp
21. Information consisting of ordinary facts unrelated to the treatment of the patient. The patient's authorization is not required to disclose the data unless the record is in a specialty hospital or in a special service unit of a general hospital - suc
nonprivileged information
(PCP) Primary Care Physician
econdary Payer
Specialist
22. A specific period of time in which employees may change insurance plans and medical groups offered by their employer and have the new insurance effective at a later date
privacy
Open Enrollment
abuse
Participating Provider
23. An individual designated ot help the provider remain in compliance by setting policies and procedures in place - and by training and managing the staff regarding HIPAA and patient rights; usually the contact person for questions and complaints.
(ERISA) Employee Retirement Income Security Act of 1974
Allowed Expenses
electronic media
Privacy officer
24. Programs designed to reduce unnecessary medical services - both inpatient and outpatient
transaction
(POS) Point-of Service Plan
(PAC) Pre- Admission Certification
(UR) Utilization review
25. Any healthcare services - that are determined by the insurance plan to be either; not generally accepted by informed healthcare professionals in the U.S. as efective in treating the condition - illness or diagnosis for which their use is proposed; or
health care provider
confidentiality
benefit period
Experimental Procedures
26. Is the provider who renders a service to a patient
Standard
Covered Expenses
Treating or performing physician
security officer
27. An intentional misrepresentation of the facts to deceive or mislead another.
(UR) Utilization review
Pre-existing Condition Exclusion
(EPO) Exclusive Provider Organization
fraud
28. Standards of conduct generally accepted as a moral guide for behavior.
pos
Privileged information
ethics
Network
29. Privately purchased individual or group health insurance policies designed to supplement Medicare coverage
Allowed Expenses
medical foundation
Medigap Insurance
attending physician
30. A notice to the insurance company that a person received care covered by the plan. A claim is also a request for payment
breach of confidential communication
Claim
self-referral
hmo
31. A clinic that is owned by the HMO and the physicians are employees of the HMO
closed panel HMO
pcp
HIPAA
Open Enrollment
32. A provider of medical or health services and any other person or organization who furnishes bills or is paid for health care in the normal course of business.
Resonable Charge
health care provider
Network
(AOB) Assignment of Benefits
33. The most money you can expect to pay for covered expenses. Once the max out-of-pocket has been met - the health plan will pay 100% of certain covered expenses
(PCN) Primary Care Network
Individually identifiable health information
Maximum Out Of Pocket
Referral
34. A willful act by an employee of taking possession of an employer's money
fraud
Embezzlement
(DRG's)
covered entity
35. An organization of provider sites with a contracted relationship that offer services
ids
Privacy officer
closed panel HMO
(COB) Coordination of Benefits
36. A managed care plan in which a range of health care services are made available to plan members for a predetermined fee per member
e-health information management
confidentiality
hmo
consulting physician
37. The period of time that payment for Medicare inpatient hospital benefits are available
benefit period
Subscriber
abuse
Medigap Insurance
38. Health Information Portability and Accountability Act
deductible
Out of Network (OON)
(PCP) Primary Care Physician
HIPAA
39. A form signed by the patient showing insurance plans assigned and their billing priority. This form allows the hospital to bill insurance on the patient's behalf and receive payment directly from the payor
Sub-acute Care
subscriber
Assignment & Authorization
clearinghouse
40. The maximum amount a plan pays for a covered service
Individually identifiable health information
Allowed Expenses
(PAC) Pre- Admission Certification
Maximum Out Of Pocket
41. A physician who specializes in a specific area of medicine - such as cardiology - oncology - urology
Specialist
etiquette
epo
cash flow
42. A portion of the covered expenses that an insured individual must pay before inusrance coverage with co-insurance goes into effect. Deductibles are usually based on a calander year
Covered Expenses
e-health information management
Deductible
(COB) Coordination of Benefits
43. A notice to the insurance company that a person received care covered by the plan. A claim is also a request for payment
(APC) Ambulatory Patient Classifications
(PCP) Primary Care Physician
ppo
Claim
44. The release - transfer - provision of access to - or divulging in any other manner of information outside the entity holding the information.
disclosure
etiquette
benefit period
Treating or performing physician
45. Medicare's method of paying acute care hospitals for inpatient care
Allowed Expenses
(PPS) Hospital Impatient Prospective Payment System
Maximum Out Of Pocket
confidentiality
46. Medical equipment which: can withstand repeated use - is used to serve a medical purpose - and appropriate for use in the home. Examples include hospital beds - wheelchairs and oxygen equipment
(DME) Durable Medical Equipment
(PEC) Pre-existing condition
(DCI) Duplicate Coverage Inquiry
complience plan
47. Any part of an individual's health information - including demographic information collected from the individual - that is created or received by a covered entity.
subscriber
Protected health information
Confidential communication
Individually identifiable health information
48. A rule - condition - or requirement
Standard
Security Rule
nonprivileged information
Claim
49. Under HIPAA - a document given to the patient at the first visit or at enrollment explaining the individual's rights and the physician's legal duties in regard to protected health information.
Notice of Privacy Practices
(TPA) Third Party Administrator
abuse
etiquette
50. Individually identifiable health information
Subscriber
breach of confidential communication
IIHI
Protected health information
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
Certifications
CISSP go to https://www.isc2.org/
PMP
ITIL
RHCE
MCTS
More...
IT Skills
Android Programming
Data Modeling
Objective C Programming
Basic Python Programming
Adobe Illustrator
More...
Business Skills
Advertising Techniques
Business Accounting Basics
Business Strategy
Human Resource Management
Marketing Basics
More...
Soft Skills
Body Language
People Skills
Public Speaking
Persuasion
Job Hunting And Resumes
More...
Vocabulary
GRE Vocab
SAT Vocab
TOEFL Essential Vocab
Basic English Words For All
Global Words You Should Know
Business English
More...
Languages
AP German Vocab
AP Latin Vocab
SAT Subject Test: French
Italian Survival
Norwegian Survival
More...
Engineering
Audio Engineering
Computer Science Engineering
Aerospace Engineering
Chemical Engineering
Structural Engineering
More...
Health Sciences
Basic Nursing Skills
Health Science Language Fundamentals
Veterinary Technology Medical Language
Cardiology
Clinical Surgery
More...
English
Grammar Fundamentals
Literary And Rhetorical Vocab
Elements Of Style Vocab
Introduction To English Major
Complete Advanced Sentences
Literature
Homonyms
More...
Math
Algebra Formulas
Basic Arithmetic: Measurements
Metric Conversions
Geometric Properties
Important Math Facts
Number Sense Vocab
Business Math
More...
Other Major Subjects
Science
Economics
History
Law
Performing-arts
Cooking
Logic & Reasoning
Trivia
Browse all subjects
Browse all tests
Most popular tests