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. An independent organization that receives insurance claims from the physician's office - performs software edits - and redistributes the claims electronically to various insurance carriers.
phantom billing
Resonable Charge
clearinghouse
Out of Network (OON)
2. 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
epo
Referral
(ERISA) Employee Retirement Income Security Act of 1974
(Non-par) Non-Participating Provider
3. The transmission of information between two parties to carry out financial or administrative activities related to health care.
Covered Expenses
transaction
nonprivileged information
deductible
4. The mode of electronic transmission (e.g. Internet - extranet - leased phone or dial-up phone lines - fax modems).
Resonable Charge
electronic media
Sub-acute Care
business associate
5. 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.
consent
ethics
Privileged information
disclosure
6. A clinic that is owned by the HMO and the physicians are employees of the HMO
closed panel HMO
(COBRA)
Pre-certification
covered entity
7. Integrating benefits payable under more than one health insurance.
consulting physician
preauthorization
AMA
Coordinated Coverage
8. A willful act by an employee of taking possession of an employer's money
(UCR) Usual - Customary and Reasonable
(PCN) Primary Care Network
health care provider
Embezzlement
9. A managed care plan in which a range of health care services are made available to plan members for a predetermined fee per member
hmo
(PEC) Pre-existing condition
(DCI) Duplicate Coverage Inquiry
Resonable Charge
10. A willful act by an employee of taking possession of an employer's money
AMA
Individually identifiable health information
IIHI
Embezzlement
11. A clinic that is owned by the HMO and the physicians are employees of the HMO
Experimental Procedures
fraud
closed panel HMO
HIPAA
12. 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
claim
Sub-acute Care
Supplementary Medical Insurance
Medigap Insurance
13. A physician who is part of am managed care plan that provides all primary health care services to members of the plan
electronic media
pcp
ethics
self-referral
14. 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
consulting physician
pos
transaction
Supplementary Medical Insurance
15. Prior approval from a health care plan administrator to receive reimbursement for surgery and other procedures to be performed
epo
Open Enrollment
preauthorization
Consent form
16. Medical services provided on an outpatient basis
Amblatory Care
Resonable Charge
(ABN) Advance Beneficiary Notice
Supplementary Medical Insurance
17. Privately purchased individual or group health insurance policies designed to supplement Medicare coverage
premium
Medigap Insurance
Notice of Privacy Practices
pos
18. Medical staff member who is legally responsible for the care and treatment given to a patient.
econdary Payer
Specialist
attending physician
Treating or performing physician
19. A list of the amount to be paid by an insurance company for each procedure service
ee schedule
(ABN) Advance Beneficiary Notice
IIHI
phantom billing
20. Any and all transations in which health care information is accessed - processed - stored - and transferred using electronic technologies.
deductible
Sub-acute Care
e-health information management
medical foundation
21. The period of time that payment for Medicare inpatient hospital benefits are available
benefit period
etiquette
Standard
Privacy officer
22. 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
(PCN) Primary Care Network
Preauthorization
health care provider
epo
23. A term used to refer to the commonly charged or prevailing fees for health services within a geographic area
ethics
ethics
(UCR) Usual - Customary and Reasonable
clearinghouse
24. A privileged communication that may be disclosed only with the patient's permission.
electronic media
(UCR) Usual - Customary and Reasonable
(AOB) Assignment of Benefits
Confidential communication
25. Paperwork for the insurance company that is required from the PCP to send a patient to see a medical specialist for treatment
open panel HMO
referral
Maximum Out Of Pocket
authorization form
26. Any medical condition that has been diagnosed or treated within a specified period immediately preceding the covered person's effective date of coverage
(PEC) Pre-existing condition
Confidential communication
pos
pos
27. A management plan composed of policies and procedures to accomplish uniformity - consistency - and conformity in medical record keeping that fulfills offical requirements.
Experimental Procedures
complience plan
Medigap Insurance
Covered Expenses
28. The portion of payments for covered health services required to be paid by the patient - including co-payments - co-insurance and deductible
Coordinated Coverage
business associate
Preauthorization
(OOPs) Out of Pocket Costs/Expenses
29. 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
(ERISA) Employee Retirement Income Security Act of 1974
confidentiality
benefit period
Pre-certification
30. 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
benefit period
Privacy officer
Preauthorization
epo
31. 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.
ppo
state preemption
Network
(PCN) Primary Care Network
32. A provider who has contracted with the health plan to deliver medical services to covered persons. This includes hospitals - pharmacies or a physician who has contractually accepted the terms and conditions as set forth by the health plan
Participating Provider
(DME) Durable Medical Equipment
(EPO) Exclusive Provider Organization
ee schedule
33. 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
Experimental Procedures
clearinghouse
Resonable Charge
Pre-existing Condition Exclusion
34. The release - transfer - provision of access to - or divulging in any other manner of information outside the entity holding the information.
etiquette
disclosure
Subscriber
business associate
35. A process of meeting regulations - recommendations - and expectations of federal and state agencies that pay for health care services and regulate the industry
Supplementary Medical Insurance
complience
e-health information management
Allowed Expenses
36. 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.
security officer
consulting physician
breach of confidential communication
Security Rule
37. An intentional misrepresentation of the facts to deceive or mislead another.
Referral
fraud
Open Enrollment
Privacy officer
38. Authorization given by a health plan for a Member to obtain services form a healthcare provider - most commonly required for hospital services
Pre-certification
econdary Payer
fraud
Sub-acute Care
39. The state of treating privately or secretly - and not disclosing to other individuals or for public knowledge - the patient's conversations or medical records.
Individually identifiable health information
(UCR) Usual - Customary and Reasonable
confidentiality
Preauthorization
40. Is the individual directing the selection - preparation - or administration of tests - medication - or treatment
Experimental Procedures
ordering physician
Network
consent
41. A rule - condition - or requirement
abuse
Standard
security officer
Pre-existing Condition Exclusion
42. A document that is not required before physicians use or disclose protected health information for treatment - payment - or routine health care operations of the patient. (For other purposes - see Authorization form)
ppo
(COBRA)
Consent form
Medigap Insurance
43. A provision that apples when a person is covered under more than one group medical program
(COB) Coordination of Benefits
(DOS) Date of Service
cash flow
(ABN) Advance Beneficiary Notice
44. Arrangement consisting of a group of providers who have a contract with an insurer - employer - third party administrator or other sponsoring group.
(EPO) Exclusive Provider Organization
preauthorization
electronic media
(UR) Utilization review
45. The amount of actual money available to the medical practice
cash flow
confidentiality
(COB) Coordination of Benefits
self-referral
46. Verbal or written agreement that gives approval to some action - situation - or statement.
complience plan
abuse
consent
claim
47. A provider whose opinion or advice about evaluation or management of a specific problem is requested by another physician
closed panel HMO
AMA
consulting physician
business associate
48. Someone who is eligible for or receiving benefits under an insurance policy or plan
ordering physician
Beneficiary
Subscriber
deductible
49. The member who holds an insurance policy providing medical coverage in return for a fixed monthly fee
disclosure
complience plan
authorization form
subscriber
50. Standards of conduct generally accepted as a moral guide for behavior.
ethics
(POS) Point-of Service Plan
(PAC) Pre- Admission Certification
Standard