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Medical Coding And Billing Clinical Vocab

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. Medicare's method of paying acute care hospitals for inpatient care






2. Incidents or practices - not usually considered fraudulent - that are inconsistent with accepted sound medical business or fiscal practices.






3. Privately purchased individual or group health insurance policies designed to supplement Medicare coverage






4. Programs designed to reduce unnecessary medical services - both inpatient and outpatient






5. 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.






6. A monthly fee paid by the insured for specific medical insurance coverage






7. A provision that apples when a person is covered under more than one group medical program






8. 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






9. 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






10. A provision that apples when a person is covered under more than one group medical program






11. Programs designed to reduce unnecessary medical services - both inpatient and outpatient






12. Integrating benefits payable under more than one health insurance.






13. Standards of conduct generally accepted as a moral guide for behavior.






14. A practice of some health insurers to deny coverage to individuals for a certain period for health conditions that already exist when coverage is initiated






15. A fee is considered 'Reasonable' if it is both usual and customary or if it is justified because there is a complex problem involved






16. The amount of actual money available to the medical practice






17. The hospital classification and reimbursement system that groups patients by diagnosis - surgical procedures - age - sex and presence of complications.

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18. Any medical condition that has been diagnosed or treated within a specified period immediately preceding the covered person's effective date of coverage






19. Arrangement consisting of a group of providers who have a contract with an insurer - employer - third party administrator or other sponsoring group.






20. A provider of medical or health services and any other person or organization who furnishes bills or is paid for health care in the normal course of business.






21. Privately purchased individual or group health insurance policies designed to supplement Medicare coverage






22. What the insurance company will consider paying for as defined in the contract.






23. A clinic that is owned by the HMO and the physicians are employees of the HMO






24. 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.






25. Individually identifiable health information






26. Individually identifiable health information






27. 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.






28. The member who holds an insurance policy providing medical coverage in return for a fixed monthly fee






29. The dates of healthcare services were provided to the beneficiary






30. A list of the amount to be paid by an insurance company for each procedure service






31. An independent person or corporate enitity(third party) that administers group benefits - claims and administration for a self-insured company or group






32. The period of time that payment for Medicare inpatient hospital benefits are available






33. 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.






34. 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






35. Unauthorized release of information






36. 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.






37. 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






38. 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.






39. 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






40. Approval or consent by a primary physician for patient referral to ancillary services and specialists






41. 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






42. Medical services provided on an outpatient basis






43. A management plan composed of policies and procedures to accomplish uniformity - consistency - and conformity in medical record keeping that fulfills offical requirements.






44. Any and all transations in which health care information is accessed - processed - stored - and transferred using electronic technologies.






45. The period of time that payment for Medicare inpatient hospital benefits are available






46. Verbal or written agreement that gives approval to some action - situation - or statement.






47. 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






48. 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






49. A nonprofit integrated delivery system






50. A managed care plan in which a range of health care services are made available to plan members for a predetermined fee per member






Can you answer 50 questions in 15 minutes?



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