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 privileged communication that may be disclosed only with the patient's permission.
Subscriber
Confidential communication
Coordinated Coverage
referral
2. 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
covered entity
etiquette
Pre-certification
Experimental Procedures
3. 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.
Protected health information
deductible
premium
(PPS) Hospital Impatient Prospective Payment System
4. A fee is considered 'Reasonable' if it is both usual and customary or if it is justified because there is a complex problem involved
Beneficiary
(OOPs) Out of Pocket Costs/Expenses
ethics
Resonable Charge
5. Standards of conduct generally accepted as a moral guide for behavior.
self-referral
breach of confidential communication
ethics
Supplementary Medical Insurance
6. 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
ee schedule
Beneficiary
Treating or performing physician
7. 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
(COBRA)
(POS) Point-of Service Plan
(ERISA) Employee Retirement Income Security Act of 1974
Assignment & Authorization
8. The condition of being secluded from the presence or view of others.
clearinghouse
(PPS) Hospital Impatient Prospective Payment System
(COB) Coordination of Benefits
privacy
9. 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
state preemption
authorization form
Network
10. 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
security officer
Open Enrollment
consent
Individually identifiable health information
11. The portion of payments for covered health services required to be paid by the patient - including co-payments - co-insurance and deductible
breach of confidential communication
hmo
(OOPs) Out of Pocket Costs/Expenses
pos
12. Someone who is eligible for or receiving benefits under an insurance policy or plan
Pre-existing Condition Exclusion
Beneficiary
Coordinated Coverage
(UCR) Usual - Customary and Reasonable
13. 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
prepaid plan
business associate
Pre-certification
Treating or performing physician
14. 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
Supplementary Medical Insurance
breach of confidential communication
clearinghouse
15. The maximum amount a plan pays for a covered service
econdary Payer
(PPS) Hospital Impatient Prospective Payment System
fraud
Allowed Expenses
16. Arrangement consisting of a group of providers who have a contract with an insurer - employer - third party administrator or other sponsoring group.
Confidential communication
(EPO) Exclusive Provider Organization
(Non-par) Non-Participating Provider
(PCP) Primary Care Physician
17. The release - transfer - provision of access to - or divulging in any other manner of information outside the entity holding the information.
disclosure
(AOB) Assignment of Benefits
open panel HMO
e-health information management
18. A nonprofit integrated delivery system
medical foundation
Covered Expenses
(PEC) Pre-existing condition
subscriber
19. 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.
business associate
state preemption
health care provider
(AOB) Assignment of Benefits
20. 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.
(TPA) Third Party Administrator
Network
(DCI) Duplicate Coverage Inquiry
health care provider
21. A physician who specializes in a specific area of medicine - such as cardiology - oncology - urology
Specialist
Protected health information
deductible
Subscriber
22. The transmission of information between two parties to carry out financial or administrative activities related to health care.
transaction
Coordinated Coverage
authorization form
(DCI) Duplicate Coverage Inquiry
23. 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
Claim
Privacy officer
hmo
24. Paperwork for the insurance company that is required from the PCP to send a patient to see a medical specialist for treatment
fraud
(COB) Coordination of Benefits
referral
Experimental Procedures
25. Authorization given by a health plan for a Member to obtain services form a healthcare provider - most commonly required for hospital services
Deductible
Pre-certification
HIPAA
Assignment & Authorization
26. 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
attending physician
covered entity
econdary Payer
transaction
27. Prior approval from a health care plan administrator to receive reimbursement for surgery and other procedures to be performed
Participating Provider
Medigap Insurance
Open Enrollment
preauthorization
28. Prior approval from a health care plan administrator to receive reimbursement for surgery and other procedures to be performed
Covered Expenses
referral
etiquette
preauthorization
29. The transmission of information between two parties to carry out financial or administrative activities related to health care.
(Non-par) Non-Participating Provider
transaction
(COB) Coordination of Benefits
(POS) Point-of Service Plan
30. The member who holds an insurance policy providing medical coverage in return for a fixed monthly fee
crossover claim
ethics
subscriber
referring physician
31. Any and all transations in which health care information is accessed - processed - stored - and transferred using electronic technologies.
ordering physician
Consent form
(COB) Coordination of Benefits
e-health information management
32. Medical services provided on an outpatient basis
(DME) Durable Medical Equipment
subscriber
Amblatory Care
(APC) Ambulatory Patient Classifications
33. A physician - the majority of whose practice is devoted to internal medicine - family/general practice and pediatrics. An ob/gyn sometimes is considerd a primary care physician depending on coverage
(PCP) Primary Care Physician
Pre-existing Condition Exclusion
clearinghouse
Supplementary Medical Insurance
34. 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
pos
ppo
confidentiality
(POS) Point-of Service Plan
35. A management plan composed of policies and procedures to accomplish uniformity - consistency - and conformity in medical record keeping that fulfills offical requirements.
complience plan
pcp
e-health information management
(AOB) Assignment of Benefits
36. A term used to refer to the commonly charged or prevailing fees for health services within a geographic area
Participating Provider
(UCR) Usual - Customary and Reasonable
clearinghouse
business associate
37. 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
referral
(PPS) Hospital Impatient Prospective Payment System
Security Rule
Privacy officer
38. Health Information Portability and Accountability Act
Resonable Charge
Standard
HIPAA
ordering physician
39. 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
AMA
Experimental Procedures
econdary Payer
Maximum Out Of Pocket
40. Programs designed to reduce unnecessary medical services - both inpatient and outpatient
Deductible
Standard
(OOPs) Out of Pocket Costs/Expenses
(UR) Utilization review
41. 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
ppo
nonprivileged information
Experimental Procedures
(COBRA)
42. An intentional misrepresentation of the facts to deceive or mislead another.
(APC) Ambulatory Patient Classifications
clearinghouse
fraud
preauthorization
43. A review of the need for inpatient hospital care - completed before the actual admission
Out of Network (OON)
consulting physician
Protected health information
(PAC) Pre- Admission Certification
44. An independent person or corporate enitity(third party) that administers group benefits - claims and administration for a self-insured company or group
(TPA) Third Party Administrator
Open Enrollment
Allowed Expenses
(UR) Utilization review
45. 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
Referral
Amblatory Care
prepaid plan
(AOB) Assignment of Benefits
46. Is a provider who sends the patients for testing or treatment
referring physician
Standard
etiquette
deductible
47. A structure for classifying outpatient services and procedures for purpose of payment
(APC) Ambulatory Patient Classifications
ee schedule
Claim
Security Rule
48. Individually identifiable health information
Privacy officer
epo
open panel HMO
IIHI
49. Integrating benefits payable under more than one health insurance.
Deductible
Coordinated Coverage
nonprivileged information
(DCI) Duplicate Coverage Inquiry
50. Any medical condition that has been diagnosed or treated within a specified period immediately preceding the covered person's effective date of coverage
Pre-certification
benefit period
(PEC) Pre-existing condition
cash flow