Test your basic knowledge |

Medical Coding And Billing Clinical Vocab

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 monthly fee paid by the insured for specific medical insurance coverage






2. The release - transfer - provision of access to - or divulging in any other manner of information outside the entity holding the information.






3. Integrating benefits payable under more than one health insurance.






4. A provision that apples when a person is covered under more than one group medical program






5. Medicare's method of paying acute care hospitals for inpatient care






6. Standards of conduct generally accepted as a moral guide for behavior.






7. A flexible health care plan that allows patients to choose using the panel of providers within the HMO network or to utilize the services of non HMO providers






8. A group of primary care physicians who have joined together to share the risk of providing care to their patients who are covered by a given health plan






9. What the insurance company will consider paying for as defined in the contract.






10. Is the individual directing the selection - preparation - or administration of tests - medication - or treatment






11. The amount of actual money available to the medical practice






12. A request to an insurance company or group medical plan by another inusrance company or medical plan to find out whether other coverage exists






13. Is the individual directing the selection - preparation - or administration of tests - medication - or treatment






14. 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.






15. Any medical condition that has been diagnosed or treated within a specified period immediately preceding the covered person's effective date of coverage






16. The Medicare program that pays for a protion of the cost of physicians' services - outpatient hospital services and other related medical and health services for voluntarily insured aged and disabled individuals






17. Integrating benefits payable under more than one health insurance.






18. 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






19. Authorization given by a health plan for a Member to obtain services form a healthcare provider - most commonly required for hospital services






20. Any and all transations in which health care information is accessed - processed - stored - and transferred using electronic technologies.






21. 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.






22. Coverage for the treatment obtained from a non-participating provider. Typically - it requires payment of a deductible and higher co-payments and co-insurance than for treatment from a participating provider






23. Paperwork for the insurance company that is required from the PCP to send a patient to see a medical specialist for treatment






24. Any data that identify an individual and describes his or her health status - age - sex - ethnicity - or other demographic characteristics - whether or not that information is stored or transmitted electronically.






25. A written and documented request for reimbursement for an eligible expense to the insurance company in a correct and timely manner






26. 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






27. Incidents or practices - not usually considered fraudulent - that are inconsistent with accepted sound medical business or fiscal practices.






28. Unauthorized release of information






29. Customs - rules of conduct - courtesy - and manners of the medical profession






30. Verbal or written agreement that gives approval to some action - situation - or statement.






31. Any and all transations in which health care information is accessed - processed - stored - and transferred using electronic technologies.






32. Prior approval from a health care plan administrator to receive reimbursement for surgery and other procedures to be performed






33. A group of primary care physicians who have joined together to share the risk of providing care to their patients who are covered by a given health plan






34. Under HIPAA - regulations related to the security of electronic protected health information that - along with regulations - related to electronic transactions and code sets - privacy - and enforcement - compose the Administrative Simplification prov






35. The dates of healthcare services were provided to the beneficiary






36. Individually identifiable health information






37. Someone who is eligible for or receiving benefits under an insurance policy or plan






38. A review of the need for inpatient hospital care - completed before the actual admission






39. Is the provider who renders a service to a patient






40. A rule - condition - or requirement






41. A patient claim is eligible for medicare and medicaid






42. Approval or consent by a primary physician for patient referral to ancillary services and specialists






43. Coverage for the treatment obtained from a non-participating provider. Typically - it requires payment of a deductible and higher co-payments and co-insurance than for treatment from a participating provider






44. 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.






45. The member who holds an insurance policy providing medical coverage in return for a fixed monthly fee






46. Medical staff member who is legally responsible for the care and treatment given to a patient.






47. Health Information Portability and Accountability Act






48. A physician who specializes in a specific area of medicine - such as cardiology - oncology - urology






49. The hospital classification and reimbursement system that groups patients by diagnosis - surgical procedures - age - sex and presence of complications.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


50. An organization of provider sites with a contracted relationship that offer services