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 management plan composed of policies and procedures to accomplish uniformity - consistency - and conformity in medical record keeping that fulfills offical requirements.
ids
clearinghouse
(UCR) Usual - Customary and Reasonable
complience plan
2. Health Information Portability and Accountability Act
breach of confidential communication
open panel HMO
(UR) Utilization review
HIPAA
3. A willful act by an employee of taking possession of an employer's money
Embezzlement
complience
pos
ppo
4. A person who protects the computer and networking systems within the practice and implements protocols such as password assignment - backup procedures - firewalls - virus protection - and contingency planning for emergencies.
Subscriber
open panel HMO
security officer
pos
5. A person - who on behalf of the covered entity - performs or assists in the performance of a function or activity involving the use or disclosure of individually identifieable health information.
health care provider
business associate
(DRG's)
e-health information management
6. 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
security officer
prepaid plan
electronic media
Network
7. An independent person or corporate enitity(third party) that administers group benefits - claims and administration for a self-insured company or group
electronic media
crossover claim
(TPA) Third Party Administrator
authorization form
8. A complex technical issue not within the scope of the health care provider's role; refers to instances when state law takes precedence over federal law.
Supplementary Medical Insurance
(APC) Ambulatory Patient Classifications
state preemption
open panel HMO
9. The portion of payments for covered health services required to be paid by the patient - including co-payments - co-insurance and deductible
(PPS) Hospital Impatient Prospective Payment System
ppo
(OOPs) Out of Pocket Costs/Expenses
Notice of Privacy Practices
10. The period of time that payment for Medicare inpatient hospital benefits are available
Out of Network (OON)
cash flow
benefit period
(OOPs) Out of Pocket Costs/Expenses
11. Is the provider who renders a service to a patient
transaction
clearinghouse
Treating or performing physician
Pre-certification
12. The person responsible for payment of premiums or whose employment is the basis for eligibility for membership in an HMO or other health plan
(Non-par) Non-Participating Provider
(DCI) Duplicate Coverage Inquiry
Subscriber
security officer
13. A practice of some health insurers to deny coverage to individuals for a certain period for health conditions that already exist when coverage is initiated
closed panel HMO
cash flow
Privileged information
Pre-existing Condition Exclusion
14. Arrangement consisting of a group of providers who have a contract with an insurer - employer - third party administrator or other sponsoring group.
Specialist
(EPO) Exclusive Provider Organization
IIHI
Subscriber
15. A structure for classifying outpatient services and procedures for purpose of payment
Assignment & Authorization
Individually identifiable health information
(APC) Ambulatory Patient Classifications
Resonable Charge
16. Usually described as a comprehensive inpatient program for those who have experienced a serious illness - injury or disease but who do not require intensive hospital services. This includes infusion therapy - respiratory care - cardiac services - wou
attending physician
Sub-acute Care
IIHI
hmo
17. A review of the need for inpatient hospital care - completed before the actual admission
Deductible
referral
(PAC) Pre- Admission Certification
Pre-certification
18. A federal law that requires employers to offer continued health insurance coverage to certain employees and their beneficiaries whose group health insurance coverage has been terminated
Coordinated Coverage
(DME) Durable Medical Equipment
(COBRA)
Sub-acute Care
19. Programs designed to reduce unnecessary medical services - both inpatient and outpatient
(TPA) Third Party Administrator
benefit period
Sub-acute Care
(UR) Utilization review
20. Privately purchased individual or group health insurance policies designed to supplement Medicare coverage
etiquette
Pre-certification
Medigap Insurance
Coordinated Coverage
21. The mode of electronic transmission (e.g. Internet - extranet - leased phone or dial-up phone lines - fax modems).
(PCP) Primary Care Physician
breach of confidential communication
subscriber
electronic media
22. A privileged communication that may be disclosed only with the patient's permission.
ee schedule
Beneficiary
claim
Confidential communication
23. A federal law that requires employers to offer continued health insurance coverage to certain employees and their beneficiaries whose group health insurance coverage has been terminated
(Non-par) Non-Participating Provider
(COBRA)
preauthorization
Notice of Privacy Practices
24. Customs - rules of conduct - courtesy - and manners of the medical profession
etiquette
(ABN) Advance Beneficiary Notice
claim
abuse
25. An independent organization that receives insurance claims from the physician's office - performs software edits - and redistributes the claims electronically to various insurance carriers.
Allowed Expenses
covered entity
clearinghouse
Referral
26. A clinic that is owned by the HMO and the physicians are employees of the HMO
(PPS) Hospital Impatient Prospective Payment System
closed panel HMO
(ABN) Advance Beneficiary Notice
benefit period
27. An authorization directing the insurer to make payment directly to a provider of benefits - such as a physician or dentist - rather than to the insured
(AOB) Assignment of Benefits
Pre-certification
abuse
consent
28. Prior approval from a health care plan administrator to receive reimbursement for surgery and other procedures to be performed
preauthorization
Experimental Procedures
hmo
Confidential communication
29. Individually identifiable health information
Consent form
Embezzlement
claim
IIHI
30. A patient claim is eligible for medicare and medicaid
crossover claim
Assignment & Authorization
(DME) Durable Medical Equipment
deductible
31. 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
referral
(PCP) Primary Care Physician
(APC) Ambulatory Patient Classifications
(Non-par) Non-Participating Provider
32. A physician who specializes in a specific area of medicine - such as cardiology - oncology - urology
premium
Covered Expenses
Privileged information
Specialist
33. A patient claim is eligible for medicare and medicaid
crossover claim
(UCR) Usual - Customary and Reasonable
pos
Security Rule
34. Any part of an individual's health information - including demographic information collected from the individual - that is created or received by a covered entity.
(PCN) Primary Care Network
Individually identifiable health information
IIHI
Confidential communication
35. Health Information Portability and Accountability Act
HIPAA
(OOPs) Out of Pocket Costs/Expenses
Participating Provider
ethics
36. Standards of conduct generally accepted as a moral guide for behavior.
Beneficiary
Out of Network (OON)
security officer
ethics
37. A monthly fee paid by the insured for specific medical insurance coverage
deductible
(ABN) Advance Beneficiary Notice
premium
referral
38. 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.
Medigap Insurance
health care provider
Privileged information
premium
39. 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.
ids
Privacy officer
Individually identifiable health information
business associate
40. A sum of money that must be paid by the patient before the insurance plan pays benefits for services rendered
Standard
subscriber
self-referral
deductible
41. Any medical condition that has been diagnosed or treated within a specified period immediately preceding the covered person's effective date of coverage
benefit period
security officer
transaction
(PEC) Pre-existing condition
42. The amount of actual money available to the medical practice
Claim
Protected health information
complience
cash flow
43. A managed care system that allows the patient to only select from a defined panel of providers - who are reimbursed on a modified fee-for-service method
hmo
fraud
disclosure
epo
44. Individually identifiable health information
(APC) Ambulatory Patient Classifications
hmo
Preauthorization
IIHI
45. A fee is considered 'Reasonable' if it is both usual and customary or if it is justified because there is a complex problem involved
(COB) Coordination of Benefits
Sub-acute Care
Resonable Charge
(PCP) Primary Care Physician
46. A notice to the insurance company that a person received care covered by the plan. A claim is also a request for payment
Open Enrollment
Confidential communication
Claim
etiquette
47. An insurance policy - plan - or program thay pays second on a claim for medical care. For children covered under two insurance plans - primary coverage will be determined by the Subscriber (mom and dad) whose month of birth is closest to the beginnin
hmo
econdary Payer
(PPS) Hospital Impatient Prospective Payment System
ethics
48. This law mandates reporting - disclosure of grievance and appeals requirements and financial standards for group life and health. Self insured plans are regulated by this law
cash flow
Embezzlement
hmo
(ERISA) Employee Retirement Income Security Act of 1974
49. 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
crossover claim
(ABN) Advance Beneficiary Notice
Participating Provider
(POS) Point-of Service Plan
50. A review of the need for inpatient hospital care - completed before the actual admission
complience plan
(DOS) Date of Service
(PAC) Pre- Admission Certification
disclosure
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