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. Is the individual directing the selection - preparation - or administration of tests - medication - or treatment
Security Rule
Privacy officer
complience plan
ordering physician
2. 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
breach of confidential communication
Supplementary Medical Insurance
Treating or performing physician
epo
3. Is the provider who renders a service to a patient
deductible
Claim
Treating or performing physician
(DME) Durable Medical Equipment
4. The member who holds an insurance policy providing medical coverage in return for a fixed monthly fee
subscriber
(AOB) Assignment of Benefits
Allowed Expenses
medical foundation
5. A managed care plan in which a range of health care services are made available to plan members for a predetermined fee per member
Notice of Privacy Practices
fraud
(PCN) Primary Care Network
hmo
6. A process of meeting regulations - recommendations - and expectations of federal and state agencies that pay for health care services and regulate the industry
privacy
epo
complience
consulting physician
7. The portion of payments for covered health services required to be paid by the patient - including co-payments - co-insurance and deductible
(OOPs) Out of Pocket Costs/Expenses
deductible
health care provider
HIPAA
8. 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.
Privileged information
referring physician
prepaid plan
Notice of Privacy Practices
9. 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
pcp
Pre-existing Condition Exclusion
Pre-certification
Maximum Out Of Pocket
10. The transmission of information between two parties to carry out financial or administrative activities related to health care.
Coordinated Coverage
IIHI
transaction
Treating or performing physician
11. 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
cash flow
(OOPs) Out of Pocket Costs/Expenses
covered entity
12. Programs designed to reduce unnecessary medical services - both inpatient and outpatient
prepaid plan
(UR) Utilization review
Sub-acute Care
Preauthorization
13. 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.
(DCI) Duplicate Coverage Inquiry
Protected health information
referral
Beneficiary
14. A health insurance enrollee chooses to see an out of network provider without authorization
(COB) Coordination of Benefits
self-referral
attending physician
(PAC) Pre- Admission Certification
15. A notice to the insurance company that a person received care covered by the plan. A claim is also a request for payment
Sub-acute Care
Claim
self-referral
Amblatory Care
16. Paperwork for the insurance company that is required from the PCP to send a patient to see a medical specialist for treatment
referral
state preemption
pos
Treating or performing physician
17. A patient claim is eligible for medicare and medicaid
crossover claim
claim
Coordinated Coverage
(PEC) Pre-existing condition
18. A list of the amount to be paid by an insurance company for each procedure service
referring physician
Pre-existing Condition Exclusion
ee schedule
ppo
19. An entity that transmits health information in electronic form in connection with a transaction covered by HIPAA. The covered entity may be a helath care coverage carrier such as Blue Cross - a health care clearinghouse through which claims are submi
hmo
covered entity
disclosure
Preauthorization
20. Standards of conduct generally accepted as a moral guide for behavior.
Privacy officer
(OOPs) Out of Pocket Costs/Expenses
ethics
Pre-existing Condition Exclusion
21. The member who holds an insurance policy providing medical coverage in return for a fixed monthly fee
(PAC) Pre- Admission Certification
etiquette
(UCR) Usual - Customary and Reasonable
subscriber
22. A document signed by the patient that is needed for use and disclosure of protected health information for purposes other than treatment - payment or health care operations
Privileged information
Sub-acute Care
privacy
authorization form
23. 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
Specialist
(AOB) Assignment of Benefits
Experimental Procedures
(POS) Point-of Service Plan
24. 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)
Consent form
Specialist
self-referral
covered entity
25. Verbal or written agreement that gives approval to some action - situation - or statement.
Pre-certification
Out of Network (OON)
disclosure
consent
26. 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
(PCN) Primary Care Network
Open Enrollment
Sub-acute Care
ethics
27. 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
Maximum Out Of Pocket
IIHI
authorization form
Allowed Expenses
28. ABN billing rules permit physicians and other Part B care providers to bill beneficiaries directly when Medicare will not cover services for lack of medical necessity
Sub-acute Care
Confidential communication
(ABN) Advance Beneficiary Notice
(OOPs) Out of Pocket Costs/Expenses
29. 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
Open Enrollment
abuse
epo
covered entity
30. A health insurance enrollee chooses to see an out of network provider without authorization
self-referral
(PCN) Primary Care Network
Sub-acute Care
Subscriber
31. A privileged communication that may be disclosed only with the patient's permission.
Confidential communication
preauthorization
(ABN) Advance Beneficiary Notice
(AOB) Assignment of Benefits
32. The release - transfer - provision of access to - or divulging in any other manner of information outside the entity holding the information.
disclosure
Treating or performing physician
(ERISA) Employee Retirement Income Security Act of 1974
(PAC) Pre- Admission Certification
33. An organization of provider sites with a contracted relationship that offer services
ids
ethics
(EPO) Exclusive Provider Organization
ppo
34. 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.
state preemption
IIHI
open panel HMO
Security Rule
35. 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
(UR) Utilization review
epo
Sub-acute Care
(ERISA) Employee Retirement Income Security Act of 1974
36. Unauthorized release of information
Preauthorization
subscriber
AMA
breach of confidential communication
37. Approval or consent by a primary physician for patient referral to ancillary services and specialists
Pre-existing Condition Exclusion
Preauthorization
Referral
complience plan
38. 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.
business associate
e-health information management
phantom billing
Notice of Privacy Practices
39. An independent organization that receives insurance claims from the physician's office - performs software edits - and redistributes the claims electronically to various insurance carriers.
premium
clearinghouse
ids
Embezzlement
40. Medical services provided on an outpatient basis
premium
ordering physician
ids
Amblatory Care
41. 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
Privileged information
cash flow
Open Enrollment
medical foundation
42. Any medical condition that has been diagnosed or treated within a specified period immediately preceding the covered person's effective date of coverage
deductible
(PEC) Pre-existing condition
referring physician
covered entity
43. 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.
Pre-existing Condition Exclusion
Protected health information
privacy
confidentiality
44. 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
crossover claim
consent
(UCR) Usual - Customary and Reasonable
45. Is the provider who renders a service to a patient
Treating or performing physician
(PAC) Pre- Admission Certification
(PCP) Primary Care Physician
self-referral
46. A provider whose opinion or advice about evaluation or management of a specific problem is requested by another physician
cash flow
security officer
consulting physician
premium
47. A document signed by the patient that is needed for use and disclosure of protected health information for purposes other than treatment - payment or health care operations
Participating Provider
authorization form
HIPAA
econdary Payer
48. 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
Supplementary Medical Insurance
(PPS) Hospital Impatient Prospective Payment System
attending physician
49. The condition of being secluded from the presence or view of others.
preauthorization
(UR) Utilization review
pos
privacy
50. The release - transfer - provision of access to - or divulging in any other manner of information outside the entity holding the information.
Allowed Expenses
Network
disclosure
(AOB) Assignment of Benefits