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 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
(DRG's)
ordering physician
(POS) Point-of Service Plan
2. A provision that apples when a person is covered under more than one group medical program
(COBRA)
(COB) Coordination of Benefits
Consent form
(TPA) Third Party Administrator
3. 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
(ERISA) Employee Retirement Income Security Act of 1974
(PEC) Pre-existing condition
Sub-acute Care
(DME) Durable Medical Equipment
4. Verbal or written agreement that gives approval to some action - situation - or statement.
Medigap Insurance
deductible
Protected health information
consent
5. 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
Privacy officer
ppo
confidentiality
pos
6. A physician who is part of am managed care plan that provides all primary health care services to members of the plan
Pre-certification
e-health information management
phantom billing
pcp
7. 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.
(ERISA) Employee Retirement Income Security Act of 1974
Privileged information
ppo
(OOPs) Out of Pocket Costs/Expenses
8. A monthly fee paid by the insured for specific medical insurance coverage
medical foundation
premium
clearinghouse
Embezzlement
9. Is the individual directing the selection - preparation - or administration of tests - medication - or treatment
Claim
subscriber
ordering physician
claim
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
Referral
Open Enrollment
ids
Consent form
11. 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.
(PEC) Pre-existing condition
state preemption
security officer
complience
12. A provider whose opinion or advice about evaluation or management of a specific problem is requested by another physician
consulting physician
Network
Participating Provider
Confidential communication
13. 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
referring physician
pos
(PPS) Hospital Impatient Prospective Payment System
Network
14. Incidents or practices - not usually considered fraudulent - that are inconsistent with accepted sound medical business or fiscal practices.
hmo
(PCN) Primary Care Network
etiquette
abuse
15. A provision that apples when a person is covered under more than one group medical program
ethics
Referral
(COB) Coordination of Benefits
Participating Provider
16. A term used to refer to the commonly charged or prevailing fees for health services within a geographic area
AMA
complience plan
crossover claim
(UCR) Usual - Customary and Reasonable
17. 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)
Sub-acute Care
covered entity
Amblatory Care
Consent form
18. A sum of money that must be paid by the patient before the insurance plan pays benefits for services rendered
(PCN) Primary Care Network
consent
Participating Provider
deductible
19. A provider whose opinion or advice about evaluation or management of a specific problem is requested by another physician
consulting physician
pcp
Experimental Procedures
ordering physician
20. 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
(COBRA)
Coordinated Coverage
attending physician
21. Is the provider who renders a service to a patient
Treating or performing physician
open panel HMO
Security Rule
hmo
22. The amount of actual money available to the medical practice
authorization form
nonprivileged information
ordering physician
cash flow
23. 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.
premium
(ABN) Advance Beneficiary Notice
Privacy officer
security officer
24. 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
(Non-par) Non-Participating Provider
security officer
(PCP) Primary Care Physician
(ABN) Advance Beneficiary Notice
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.
Referral
(EPO) Exclusive Provider Organization
premium
clearinghouse
26. American Medical Association
AMA
Protected health information
Preauthorization
ordering physician
27. 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.
confidentiality
health care provider
hmo
Privacy officer
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
Allowed Expenses
(ABN) Advance Beneficiary Notice
Notice of Privacy Practices
business associate
29. Someone who is eligible for or receiving benefits under an insurance policy or plan
(DME) Durable Medical Equipment
deductible
ee schedule
Beneficiary
30. 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
(ERISA) Employee Retirement Income Security Act of 1974
attending physician
(TPA) Third Party Administrator
authorization form
31. Programs designed to reduce unnecessary medical services - both inpatient and outpatient
business associate
Allowed Expenses
(OOPs) Out of Pocket Costs/Expenses
(UR) Utilization review
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
Protected health information
nonprivileged information
(ABN) Advance Beneficiary Notice
Participating Provider
33. A request to an insurance company or group medical plan by another inusrance company or medical plan to find out whether other coverage exists
Amblatory Care
nonprivileged information
Pre-existing Condition Exclusion
(DCI) Duplicate Coverage Inquiry
34. Is a provider who sends the patients for testing or treatment
clearinghouse
AMA
(COBRA)
referring physician
35. A term used to refer to the commonly charged or prevailing fees for health services within a geographic area
Subscriber
(UCR) Usual - Customary and Reasonable
pos
abuse
36. Medicare's method of paying acute care hospitals for inpatient care
(PPS) Hospital Impatient Prospective Payment System
transaction
business associate
attending physician
37. 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
Network
phantom billing
AMA
Out of Network (OON)
38. A structure for classifying outpatient services and procedures for purpose of payment
(APC) Ambulatory Patient Classifications
clearinghouse
consent
security officer
39. 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
(AOB) Assignment of Benefits
(DME) Durable Medical Equipment
Security Rule
(PCP) Primary Care Physician
40. A notice to the insurance company that a person received care covered by the plan. A claim is also a request for payment
self-referral
(DME) Durable Medical Equipment
Claim
medical foundation
41. A health care plan that stipulates that the patient must use a medical provider who is under contract with the insurer for an agreed on fee
(PCP) Primary Care Physician
ppo
(PAC) Pre- Admission Certification
Consent form
42. The release - transfer - provision of access to - or divulging in any other manner of information outside the entity holding the information.
disclosure
(POS) Point-of Service Plan
Embezzlement
Protected health information
43. 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
44. Approval or consent by a primary physician for patient referral to ancillary services and specialists
Referral
IIHI
prepaid plan
consent
45. Any and all transations in which health care information is accessed - processed - stored - and transferred using electronic technologies.
e-health information management
Resonable Charge
(DME) Durable Medical Equipment
(COBRA)
46. Programs designed to reduce unnecessary medical services - both inpatient and outpatient
(UR) Utilization review
(COB) Coordination of Benefits
Notice of Privacy Practices
fraud
47. An organization of provider sites with a contracted relationship that offer services
abuse
ids
Resonable Charge
(DOS) Date of Service
48. An independent person or corporate enitity(third party) that administers group benefits - claims and administration for a self-insured company or group
Medigap Insurance
Pre-certification
confidentiality
(TPA) Third Party Administrator
49. A written and documented request for reimbursement for an eligible expense to the insurance company in a correct and timely manner
pcp
claim
etiquette
ordering physician
50. Any medical condition that has been diagnosed or treated within a specified period immediately preceding the covered person's effective date of coverage
Beneficiary
(PEC) Pre-existing condition
nonprivileged information
Covered Expenses