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 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.
clearinghouse
ppo
(DME) Durable Medical Equipment
security officer
2. 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
epo
Participating Provider
Coordinated Coverage
(PCP) Primary Care Physician
3. A health insurance enrollee chooses to see an out of network provider without authorization
Medigap Insurance
self-referral
Embezzlement
Confidential communication
4. 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
(Non-par) Non-Participating Provider
Participating Provider
etiquette
authorization form
5. The condition of being secluded from the presence or view of others.
open panel HMO
Standard
Participating Provider
privacy
6. Paperwork for the insurance company that is required from the PCP to send a patient to see a medical specialist for treatment
fraud
(UCR) Usual - Customary and Reasonable
referral
(PCN) Primary Care Network
7. 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
Deductible
Covered Expenses
(DME) Durable Medical Equipment
Confidential communication
8. Medicare's method of paying acute care hospitals for inpatient care
clearinghouse
(PPS) Hospital Impatient Prospective Payment System
(COBRA)
complience
9. The transmission of information between two parties to carry out financial or administrative activities related to health care.
attending physician
Notice of Privacy Practices
security officer
transaction
10. An independent person or corporate enitity(third party) that administers group benefits - claims and administration for a self-insured company or group
Privileged information
Experimental Procedures
(TPA) Third Party Administrator
electronic media
11. An organization of provider sites with a contracted relationship that offer services
ids
(UR) Utilization review
econdary Payer
nonprivileged information
12. 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
ethics
(Non-par) Non-Participating Provider
epo
(APC) Ambulatory Patient Classifications
13. 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
Out of Network (OON)
self-referral
subscriber
14. 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
(DCI) Duplicate Coverage Inquiry
(UCR) Usual - Customary and Reasonable
Sub-acute Care
Beneficiary
15. Is the individual directing the selection - preparation - or administration of tests - medication - or treatment
ordering physician
(ABN) Advance Beneficiary Notice
referral
(PEC) Pre-existing condition
16. A managed care plan in which a range of health care services are made available to plan members for a predetermined fee per member
preauthorization
Beneficiary
referral
hmo
17. 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.
Notice of Privacy Practices
Claim
epo
Individually identifiable health information
18. A managed care plan in which a range of health care services are made available to plan members for a predetermined fee per member
Participating Provider
(COB) Coordination of Benefits
hmo
(EPO) Exclusive Provider Organization
19. A nonprofit integrated delivery system
(PPS) Hospital Impatient Prospective Payment System
etiquette
medical foundation
referring physician
20. 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
(COBRA)
Embezzlement
Consent form
Deductible
21. A willful act by an employee of taking possession of an employer's money
preauthorization
Embezzlement
covered entity
Experimental Procedures
22. Medical staff member who is legally responsible for the care and treatment given to a patient.
(Non-par) Non-Participating Provider
(ABN) Advance Beneficiary Notice
subscriber
attending physician
23. Is a provider who sends the patients for testing or treatment
(PCN) Primary Care Network
claim
referring physician
Claim
24. A monthly fee paid by the insured for specific medical insurance coverage
(APC) Ambulatory Patient Classifications
Embezzlement
premium
HIPAA
25. The transmission of information between two parties to carry out financial or administrative activities related to health care.
transaction
Beneficiary
Amblatory Care
Covered Expenses
26. 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.
privacy
(ERISA) Employee Retirement Income Security Act of 1974
Privileged information
Confidential communication
27. 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)
(UCR) Usual - Customary and Reasonable
(OOPs) Out of Pocket Costs/Expenses
security officer
28. A physician who specializes in a specific area of medicine - such as cardiology - oncology - urology
Experimental Procedures
Specialist
consulting physician
hmo
29. 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.
(PEC) Pre-existing condition
deductible
(PCN) Primary Care Network
Privacy officer
30. Physicians - hospitals and other healthcare providers that an HMO - PPO or other managed care network has selected to provide care for its members
(UCR) Usual - Customary and Reasonable
Network
(OOPs) Out of Pocket Costs/Expenses
state preemption
31. Is a provider who sends the patients for testing or treatment
referring physician
epo
Participating Provider
(PPS) Hospital Impatient Prospective Payment System
32. Also known as out-of-network provider. A healthcare provider who has not contracted with the carrier of a health plan to be a participating provider of healthcare
(Non-par) Non-Participating Provider
(UR) Utilization review
(COB) Coordination of Benefits
consulting physician
33. A management plan composed of policies and procedures to accomplish uniformity - consistency - and conformity in medical record keeping that fulfills offical requirements.
complience plan
consent
Notice of Privacy Practices
Embezzlement
34. The period of time that payment for Medicare inpatient hospital benefits are available
nonprivileged information
Pre-existing Condition Exclusion
benefit period
pos
35. 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
state preemption
claim
prepaid plan
36. 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
referring physician
electronic media
ordering physician
econdary Payer
37. Physicians - hospitals and other healthcare providers that an HMO - PPO or other managed care network has selected to provide care for its members
Network
privacy
Resonable Charge
nonprivileged information
38. Individually identifiable health information
(DOS) Date of Service
(Non-par) Non-Participating Provider
hmo
IIHI
39. Medical services provided on an outpatient basis
Amblatory Care
authorization form
open panel HMO
(UCR) Usual - Customary and Reasonable
40. A form signed by the patient showing insurance plans assigned and their billing priority. This form allows the hospital to bill insurance on the patient's behalf and receive payment directly from the payor
Assignment & Authorization
confidentiality
e-health information management
covered entity
41. 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
preauthorization
e-health information management
pos
deductible
42. Prior approval from a health care plan administrator to receive reimbursement for surgery and other procedures to be performed
crossover claim
authorization form
Privileged information
preauthorization
43. The mode of electronic transmission (e.g. Internet - extranet - leased phone or dial-up phone lines - fax modems).
state preemption
consent
epo
electronic media
44. Any and all transations in which health care information is accessed - processed - stored - and transferred using electronic technologies.
Maximum Out Of Pocket
abuse
security officer
e-health information management
45. A monthly fee paid by the insured for specific medical insurance coverage
Deductible
(COB) Coordination of Benefits
Experimental Procedures
premium
46. 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
hmo
breach of confidential communication
ethics
econdary Payer
47. 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
referral
Privileged information
pos
self-referral
48. 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
(COBRA)
business associate
(ERISA) Employee Retirement Income Security Act of 1974
AMA
49. 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)
(COBRA)
Consent form
Standard
(DME) Durable Medical Equipment
50. 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
Coordinated Coverage
self-referral
attending physician
prepaid plan