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. The mode of electronic transmission (e.g. Internet - extranet - leased phone or dial-up phone lines - fax modems).
ethics
electronic media
Treating or performing physician
complience
2. Is a provider who sends the patients for testing or treatment
benefit period
referring physician
complience
Pre-existing Condition Exclusion
3. Health Information Portability and Accountability Act
electronic media
self-referral
Open Enrollment
HIPAA
4. A written and documented request for reimbursement for an eligible expense to the insurance company in a correct and timely manner
Experimental Procedures
business associate
privacy
claim
5. 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
closed panel HMO
ordering physician
Sub-acute Care
Out of Network (OON)
6. 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
HIPAA
Medigap Insurance
Consent form
Deductible
7. Is the individual directing the selection - preparation - or administration of tests - medication - or treatment
Experimental Procedures
consulting physician
ordering physician
transaction
8. A clinic that is owned by the HMO and the physicians are employees of the HMO
(DCI) Duplicate Coverage Inquiry
medical foundation
(PEC) Pre-existing condition
closed panel HMO
9. Is a provider who sends the patients for testing or treatment
referring physician
Allowed Expenses
preauthorization
e-health information management
10. 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
Out of Network (OON)
ppo
Allowed Expenses
11. 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
confidentiality
(PCN) Primary Care Network
(DCI) Duplicate Coverage Inquiry
Referral
12. 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
fraud
Open Enrollment
(UCR) Usual - Customary and Reasonable
covered entity
13. Prior approval from a health care plan administrator to receive reimbursement for surgery and other procedures to be performed
(DCI) Duplicate Coverage Inquiry
(PCN) Primary Care Network
preauthorization
(POS) Point-of Service Plan
14. 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
Experimental Procedures
privacy
Open Enrollment
Security Rule
15. 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
Embezzlement
privacy
premium
(ABN) Advance Beneficiary Notice
16. 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
ethics
(POS) Point-of Service Plan
complience
Amblatory Care
17. Individually identifiable health information
phantom billing
IIHI
ee schedule
confidentiality
18. Integrating benefits payable under more than one health insurance.
(PCP) Primary Care Physician
Referral
Coordinated Coverage
(Non-par) Non-Participating Provider
19. The dates of healthcare services were provided to the beneficiary
(APC) Ambulatory Patient Classifications
Open Enrollment
Network
(DOS) Date of Service
20. A privileged communication that may be disclosed only with the patient's permission.
Covered Expenses
Confidential communication
premium
referral
21. An independent person or corporate enitity(third party) that administers group benefits - claims and administration for a self-insured company or group
Referral
confidentiality
(TPA) Third Party Administrator
Individually identifiable health information
22. A list of the amount to be paid by an insurance company for each procedure service
AMA
ee schedule
Network
authorization form
23. 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
Privileged information
Standard
Experimental Procedures
24. A provider whose opinion or advice about evaluation or management of a specific problem is requested by another physician
Medigap Insurance
crossover claim
consulting physician
Privacy officer
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)
covered entity
complience plan
Claim
Consent form
26. Any part of an individual's health information - including demographic information collected from the individual - that is created or received by a covered entity.
Deductible
(DOS) Date of Service
Individually identifiable health information
Security Rule
27. A physician who specializes in a specific area of medicine - such as cardiology - oncology - urology
breach of confidential communication
deductible
Specialist
ethics
28. The dates of healthcare services were provided to the beneficiary
(DOS) Date of Service
consent
deductible
Preauthorization
29. The release - transfer - provision of access to - or divulging in any other manner of information outside the entity holding the information.
referring physician
disclosure
Supplementary Medical Insurance
e-health information management
30. Is the provider who renders a service to a patient
(DOS) Date of Service
business associate
Treating or performing physician
Maximum Out Of Pocket
31. 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
ids
Individually identifiable health information
epo
deductible
32. 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.
(COBRA)
pos
ethics
Protected health information
33. 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.
Individually identifiable health information
Treating or performing physician
Network
Privileged information
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.
(OOPs) Out of Pocket Costs/Expenses
state preemption
(EPO) Exclusive Provider Organization
IIHI
35. 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
privacy
Preauthorization
Experimental Procedures
Network
36. 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
Referral
(AOB) Assignment of Benefits
referral
(UCR) Usual - Customary and Reasonable
37. 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
(DCI) Duplicate Coverage Inquiry
closed panel HMO
phantom billing
ppo
38. A written and documented request for reimbursement for an eligible expense to the insurance company in a correct and timely manner
claim
etiquette
state preemption
ethics
39. Verbal or written agreement that gives approval to some action - situation - or statement.
Treating or performing physician
Sub-acute Care
consent
ordering physician
40. Privately purchased individual or group health insurance policies designed to supplement Medicare coverage
Deductible
Medigap Insurance
Privacy officer
(OOPs) Out of Pocket Costs/Expenses
41. A sum of money that must be paid by the patient before the insurance plan pays benefits for services rendered
Treating or performing physician
deductible
(APC) Ambulatory Patient Classifications
Privileged information
42. 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
Supplementary Medical Insurance
(OOPs) Out of Pocket Costs/Expenses
(COBRA)
disclosure
43. An independent organization that receives insurance claims from the physician's office - performs software edits - and redistributes the claims electronically to various insurance carriers.
Confidential communication
clearinghouse
health care provider
benefit period
44. An organization of provider sites with a contracted relationship that offer services
Assignment & Authorization
clearinghouse
ids
ppo
45. 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
Supplementary Medical Insurance
state preemption
(POS) Point-of Service Plan
(UR) Utilization review
46. Someone who is eligible for or receiving benefits under an insurance policy or plan
IIHI
(PEC) Pre-existing condition
Beneficiary
(Non-par) Non-Participating Provider
47. Programs designed to reduce unnecessary medical services - both inpatient and outpatient
Referral
consent
(UR) Utilization review
Amblatory Care
48. A process of meeting regulations - recommendations - and expectations of federal and state agencies that pay for health care services and regulate the industry
(COBRA)
etiquette
complience
security officer
49. A review of the need for inpatient hospital care - completed before the actual admission
econdary Payer
(PAC) Pre- Admission Certification
electronic media
IIHI
50. The amount of actual money available to the medical practice
(COBRA)
cash flow
abuse
(APC) Ambulatory Patient Classifications