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. Programs designed to reduce unnecessary medical services - both inpatient and outpatient
(UR) Utilization review
deductible
authorization form
(DOS) Date of Service
2. A review of the need for inpatient hospital care - completed before the actual admission
complience
etiquette
pos
(PAC) Pre- Admission Certification
3. An intentional misrepresentation of the facts to deceive or mislead another.
(AOB) Assignment of Benefits
(PAC) Pre- Admission Certification
(PEC) Pre-existing condition
fraud
4. 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
state preemption
subscriber
Covered Expenses
Deductible
5. Customs - rules of conduct - courtesy - and manners of the medical profession
Embezzlement
Participating Provider
breach of confidential communication
etiquette
6. 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
ppo
Pre-existing Condition Exclusion
Claim
(PAC) Pre- Admission Certification
7. The person responsible for payment of premiums or whose employment is the basis for eligibility for membership in an HMO or other health plan
Covered Expenses
(OOPs) Out of Pocket Costs/Expenses
ppo
Subscriber
8. 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.
Subscriber
Supplementary Medical Insurance
Notice of Privacy Practices
Standard
9. 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
business associate
Participating Provider
Beneficiary
(COBRA)
10. A health insurance enrollee chooses to see an out of network provider without authorization
HIPAA
self-referral
crossover claim
state preemption
11. 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
(POS) Point-of Service Plan
ee schedule
confidentiality
12. The maximum amount a plan pays for a covered service
Allowed Expenses
electronic media
deductible
cash flow
13. Individually identifiable health information
IIHI
(PAC) Pre- Admission Certification
(DCI) Duplicate Coverage Inquiry
Out of Network (OON)
14. Someone who is eligible for or receiving benefits under an insurance policy or plan
Confidential communication
(OOPs) Out of Pocket Costs/Expenses
abuse
Beneficiary
15. 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
Resonable Charge
(ERISA) Employee Retirement Income Security Act of 1974
Open Enrollment
(APC) Ambulatory Patient Classifications
16. An independent organization that receives insurance claims from the physician's office - performs software edits - and redistributes the claims electronically to various insurance carriers.
Assignment & Authorization
clearinghouse
transaction
(EPO) Exclusive Provider Organization
17. A provision that apples when a person is covered under more than one group medical program
state preemption
(COB) Coordination of Benefits
electronic media
Confidential communication
18. A provider whose opinion or advice about evaluation or management of a specific problem is requested by another physician
attending physician
consulting physician
Privacy officer
abuse
19. The portion of payments for covered health services required to be paid by the patient - including co-payments - co-insurance and deductible
ppo
(UCR) Usual - Customary and Reasonable
breach of confidential communication
(OOPs) Out of Pocket Costs/Expenses
20. An organization of provider sites with a contracted relationship that offer services
(DRG's)
nonprivileged information
ids
Participating Provider
21. A management plan composed of policies and procedures to accomplish uniformity - consistency - and conformity in medical record keeping that fulfills offical requirements.
open panel HMO
(DOS) Date of Service
complience plan
closed panel HMO
22. 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
epo
complience plan
Supplementary Medical Insurance
claim
23. A rule - condition - or requirement
Standard
Security Rule
Amblatory Care
Assignment & Authorization
24. 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
attending physician
(PCN) Primary Care Network
Coordinated Coverage
referral
25. Is the provider who renders a service to a patient
(ABN) Advance Beneficiary Notice
Embezzlement
Treating or performing physician
Participating Provider
26. The portion of payments for covered health services required to be paid by the patient - including co-payments - co-insurance and deductible
(OOPs) Out of Pocket Costs/Expenses
Treating or performing physician
(DCI) Duplicate Coverage Inquiry
(POS) Point-of Service Plan
27. An organization of provider sites with a contracted relationship that offer services
(DCI) Duplicate Coverage Inquiry
ids
benefit period
pos
28. Privately purchased individual or group health insurance policies designed to supplement Medicare coverage
hmo
Network
Medigap Insurance
pcp
29. 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
Sub-acute Care
Open Enrollment
(OOPs) Out of Pocket Costs/Expenses
Embezzlement
30. A term used to refer to the commonly charged or prevailing fees for health services within a geographic area
(POS) Point-of Service Plan
ee schedule
authorization form
(UCR) Usual - Customary and Reasonable
31. 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
referral
Allowed Expenses
Assignment & Authorization
attending physician
32. A request to an insurance company or group medical plan by another inusrance company or medical plan to find out whether other coverage exists
preauthorization
Deductible
(DCI) Duplicate Coverage Inquiry
(DOS) Date of Service
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
Participating Provider
(PCP) Primary Care Physician
covered entity
pos
34. A written and documented request for reimbursement for an eligible expense to the insurance company in a correct and timely manner
(PEC) Pre-existing condition
claim
state preemption
preauthorization
35. A structure for classifying outpatient services and procedures for purpose of payment
confidentiality
Coordinated Coverage
Allowed Expenses
(APC) Ambulatory Patient Classifications
36. 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
37. The transmission of information between two parties to carry out financial or administrative activities related to health care.
premium
(Non-par) Non-Participating Provider
complience plan
transaction
38. A health care provider that is not employed by the HMO and does not belong to a medical group owned or managed by the HMO
(ERISA) Employee Retirement Income Security Act of 1974
open panel HMO
Beneficiary
Coordinated Coverage
39. 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
(PEC) Pre-existing condition
referring physician
(UCR) Usual - Customary and Reasonable
40. Standards of conduct generally accepted as a moral guide for behavior.
subscriber
ordering physician
ethics
Participating Provider
41. 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
etiquette
Deductible
covered entity
ppo
42. A patient claim is eligible for medicare and medicaid
(PCP) Primary Care Physician
Assignment & Authorization
Standard
crossover claim
43. 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
Claim
crossover claim
ppo
44. 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
ethics
state preemption
prepaid plan
(Non-par) Non-Participating Provider
45. 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.
deductible
closed panel HMO
Privacy officer
crossover claim
46. A health care provider that is not employed by the HMO and does not belong to a medical group owned or managed by the HMO
attending physician
open panel HMO
Consent form
state preemption
47. Paperwork for the insurance company that is required from the PCP to send a patient to see a medical specialist for treatment
referral
Supplementary Medical Insurance
crossover claim
Coordinated Coverage
48. 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
(UCR) Usual - Customary and Reasonable
AMA
Confidential communication
authorization form
49. The dates of healthcare services were provided to the beneficiary
phantom billing
(DOS) Date of Service
Open Enrollment
Preauthorization
50. Someone who is eligible for or receiving benefits under an insurance policy or plan
Coordinated Coverage
Beneficiary
subscriber
complience plan
Sorry!:) No result found.
Can you answer 50 questions in 15 minutes?
Let me suggest you:
Browse all subjects
Browse all tests
Most popular tests
Major Subjects
Tests & Exams
AP
CLEP
DSST
GRE
SAT
GMAT
Certifications
CISSP go to https://www.isc2.org/
PMP
ITIL
RHCE
MCTS
More...
IT Skills
Android Programming
Data Modeling
Objective C Programming
Basic Python Programming
Adobe Illustrator
More...
Business Skills
Advertising Techniques
Business Accounting Basics
Business Strategy
Human Resource Management
Marketing Basics
More...
Soft Skills
Body Language
People Skills
Public Speaking
Persuasion
Job Hunting And Resumes
More...
Vocabulary
GRE Vocab
SAT Vocab
TOEFL Essential Vocab
Basic English Words For All
Global Words You Should Know
Business English
More...
Languages
AP German Vocab
AP Latin Vocab
SAT Subject Test: French
Italian Survival
Norwegian Survival
More...
Engineering
Audio Engineering
Computer Science Engineering
Aerospace Engineering
Chemical Engineering
Structural Engineering
More...
Health Sciences
Basic Nursing Skills
Health Science Language Fundamentals
Veterinary Technology Medical Language
Cardiology
Clinical Surgery
More...
English
Grammar Fundamentals
Literary And Rhetorical Vocab
Elements Of Style Vocab
Introduction To English Major
Complete Advanced Sentences
Literature
Homonyms
More...
Math
Algebra Formulas
Basic Arithmetic: Measurements
Metric Conversions
Geometric Properties
Important Math Facts
Number Sense Vocab
Business Math
More...
Other Major Subjects
Science
Economics
History
Law
Performing-arts
Cooking
Logic & Reasoning
Trivia
Browse all subjects
Browse all tests
Most popular tests