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Test your basic knowledge |
Medical Coding And Billing Clinical Vocab
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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. 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
cash flow
(COB) Coordination of Benefits
(DME) Durable Medical Equipment
(COB) Coordination of Benefits
2. 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.
business associate
Privileged information
(COB) Coordination of Benefits
etiquette
3. Individually identifiable health information
preauthorization
IIHI
Privacy officer
(PCN) Primary Care Network
4. Health Information Portability and Accountability Act
ordering physician
Standard
HIPAA
hmo
5. 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
Security Rule
AMA
Claim
6. 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)
authorization form
Participating Provider
etiquette
Consent form
7. A physician who is part of am managed care plan that provides all primary health care services to members of the plan
consent
pcp
(DRG's)
(TPA) Third Party Administrator
8. The hospital classification and reimbursement system that groups patients by diagnosis - surgical procedures - age - sex and presence of complications.
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9. The maximum amount a plan pays for a covered service
(DRG's)
etiquette
health care provider
Allowed Expenses
10. A request to an insurance company or group medical plan by another inusrance company or medical plan to find out whether other coverage exists
Deductible
(DCI) Duplicate Coverage Inquiry
security officer
ppo
11. A monthly fee paid by the insured for specific medical insurance coverage
premium
(UCR) Usual - Customary and Reasonable
Covered Expenses
ee schedule
12. 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.
Open Enrollment
Protected health information
Standard
referral
13. 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
Out of Network (OON)
HIPAA
Pre-existing Condition Exclusion
Individually identifiable health information
14. A monthly fee paid by the insured for specific medical insurance coverage
premium
abuse
Pre-existing Condition Exclusion
consent
15. 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.
Protected health information
clearinghouse
(Non-par) Non-Participating Provider
state preemption
16. A fee is considered 'Reasonable' if it is both usual and customary or if it is justified because there is a complex problem involved
Resonable Charge
fraud
econdary Payer
(ERISA) Employee Retirement Income Security Act of 1974
17. 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.
pcp
e-health information management
business associate
benefit period
18. A clinic that is owned by the HMO and the physicians are employees of the HMO
Subscriber
Protected health information
Embezzlement
closed panel HMO
19. An independent person or corporate enitity(third party) that administers group benefits - claims and administration for a self-insured company or group
(DCI) Duplicate Coverage Inquiry
cash flow
transaction
(TPA) Third Party Administrator
20. American Medical Association
(COBRA)
AMA
(POS) Point-of Service Plan
ethics
21. Is the individual directing the selection - preparation - or administration of tests - medication - or treatment
ordering physician
closed panel HMO
Deductible
Resonable Charge
22. 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
HIPAA
IIHI
(POS) Point-of Service Plan
23. 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
complience plan
referral
ppo
transaction
24. Any part of an individual's health information - including demographic information collected from the individual - that is created or received by a covered entity.
(TPA) Third Party Administrator
(DME) Durable Medical Equipment
premium
Individually identifiable health information
25. 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
transaction
hmo
business associate
26. Integrating benefits payable under more than one health insurance.
medical foundation
Coordinated Coverage
Covered Expenses
attending physician
27. 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
(UR) Utilization review
hmo
epo
28. 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
(PEC) Pre-existing condition
ee schedule
Out of Network (OON)
pos
29. A review of the need for inpatient hospital care - completed before the actual admission
(PAC) Pre- Admission Certification
(DME) Durable Medical Equipment
Individually identifiable health information
premium
30. 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
complience
(ABN) Advance Beneficiary Notice
(AOB) Assignment of Benefits
31. A management plan composed of policies and procedures to accomplish uniformity - consistency - and conformity in medical record keeping that fulfills offical requirements.
complience plan
(UCR) Usual - Customary and Reasonable
(ABN) Advance Beneficiary Notice
(Non-par) Non-Participating Provider
32. Privately purchased individual or group health insurance policies designed to supplement Medicare coverage
Out of Network (OON)
Medigap Insurance
IIHI
(PCN) Primary Care Network
33. Prior approval from a health care plan administrator to receive reimbursement for surgery and other procedures to be performed
privacy
electronic media
preauthorization
deductible
34. A fee is considered 'Reasonable' if it is both usual and customary or if it is justified because there is a complex problem involved
(COBRA)
ee schedule
Resonable Charge
crossover claim
35. 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
etiquette
electronic media
Consent form
Open Enrollment
36. An insurance plan requirement in which you or your primary care physician need to notify your insurance company in advance about certain medical procedures in order for those procedures to be considered a covered expense
Preauthorization
Maximum Out Of Pocket
subscriber
(DME) Durable Medical Equipment
37. Billing for services not performed
Notice of Privacy Practices
phantom billing
epo
e-health information management
38. A privileged communication that may be disclosed only with the patient's permission.
Confidential communication
(UCR) Usual - Customary and Reasonable
Medigap Insurance
state preemption
39. Paperwork for the insurance company that is required from the PCP to send a patient to see a medical specialist for treatment
preauthorization
(POS) Point-of Service Plan
referral
e-health information management
40. The state of treating privately or secretly - and not disclosing to other individuals or for public knowledge - the patient's conversations or medical records.
confidentiality
deductible
Embezzlement
AMA
41. The dates of healthcare services were provided to the beneficiary
Specialist
transaction
(DOS) Date of Service
deductible
42. Prior approval from a health care plan administrator to receive reimbursement for surgery and other procedures to be performed
Individually identifiable health information
(ABN) Advance Beneficiary Notice
econdary Payer
preauthorization
43. Incidents or practices - not usually considered fraudulent - that are inconsistent with accepted sound medical business or fiscal practices.
Treating or performing physician
Embezzlement
abuse
Notice of Privacy Practices
44. A portion of the covered expenses that an insured individual must pay before inusrance coverage with co-insurance goes into effect. Deductibles are usually based on a calander year
Coordinated Coverage
Deductible
medical foundation
(COBRA)
45. 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
closed panel HMO
(PCN) Primary Care Network
closed panel HMO
complience
46. A review of the need for inpatient hospital care - completed before the actual admission
privacy
(UCR) Usual - Customary and Reasonable
(PAC) Pre- Admission Certification
(PPS) Hospital Impatient Prospective Payment System
47. 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
HIPAA
(COBRA)
Experimental Procedures
health care provider
48. 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
(PPS) Hospital Impatient Prospective Payment System
Claim
(DOS) Date of Service
49. A clinic that is owned by the HMO and the physicians are employees of the HMO
Confidential communication
closed panel HMO
(COB) Coordination of Benefits
etiquette
50. 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.
Standard
Protected health information
Referral
(TPA) Third Party Administrator