Patient Access Week Crossword
Type
Crossword
Description

Meeting where coworker issues are resolved
Federal law requiring employers to permit employees to continue their group health insurance coverage after termination
Health Insurance _____________and Accountability Act
Cost sharing in which the subscriber is responsible for a specific percentage of the cost of healthcare
(2 words) Tool that utilizes fee schedules, payer contracts, and benefits to calculate a cost estimate
(3 words) A Mercy program where the patient can receive a reduction in total costs as long as the account is over 45 days old
An insurance coverage that doesn't require authorization
Fixed sum of money that the beneficiary must contribute towards the cost of their healthcare before insurance benefits begin
The person who is financially responsible for the account
Questionnaire to determine primary payor before Medicare

PATIENT ACCESS Crossword

PATIENT ACCESS Crossword
Type
Crossword
Description

Health Maintenance Organization; A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the
Fixed sum of money that beneficiary must contribute towards the cost of their healthcare before insurance benefits begin
Official count/list of patient population
Not to be disclosed
Federal health insurance plan primarily for seniors
The administrative branch within the Department of Health and Human Services that is responsible for Medicare and Medicaid Services
ost sharing in which the subscriber is responsible for a specific percentage of the cost of healthcare
Person who is the holder of an insurance policy
Questionnaire to determine primary payor before Medicare
ederal law requiring employers to permit employees to continue their group health insurance coverage after termination
A fixed payment for a covered service
Preferred Provider Organization
oint federal and state program to provide Medical insurance for the poor
Collection and storage on patient demographic, insurance, and clinical data

Patient Access Crossword

Patient Access  Crossword
Type
Crossword
Description

federal health insurance plan primarily for seniors
setting for inpatient care
federal law requiring employer to permit employees to continue their group health insurance coverage after termination
conducting ourselves ethically and within the law of business practice
collection and storage on patient demographic, insurance and clinical data
official count/list of patient population
document verifying patient name
portion of bill that beneficiary must pay once insurance benefits have begun
a practice to reduce anxiety
joint federal and state program to provide medical insurance for the poor
having a short, relatively severe course
not to be disclosed
making an appointment
ambulatory patient
admitted for multi-day stay
healthcare consumer
ABN Advance _______ notice
MSP Medicare ________ payor
EMTALA Emergency Medical Treatment and ______ Act

Patient Access Week 2017 Crossword

Patient Access Week 2017 Crossword
Type
Crossword
Description

Cost sharing in which the subscriber is responsible for a specific percentage of the cost of healthcare
(3 words) A Mercy program where the patient can receive a reduction in total costs as long as the account is over 45 days old
Fixed sum of money that the beneficiary must contribute towards the cost of their healthcare before insurance benefits begin
The person who is financially responsible for the account
Questionnaire to determine primary payor before Medicare
Meeting where coworker issues are resolved
Federal law requiring employers to permit employees to continue their group health insurance coverage after termination
Health Insurance _____________and Accountability Act
(2 words) Tool that utilizes fee schedules, payer contracts, and benefits to calculate a cost estimate
An insurance coverage that doesn't require authorization
Not to be disclosed
Collection and storage of patient demographic, insurance, and emergency information
(2 words) Balances patients may owe from previous visits
(2 words) Prior balances that have been turned over to collection agencies
Our Director's name

Healthcare Vocabulary Crossword

Healthcare Vocabulary Crossword
Type
Crossword
Description

A contract with a company where the subscriber pays a regular premium in exchange for a defined set of benefits
Reffered to as family doctor/PCP this person administers routine and preventive care, and makes referrals for specialty services when needed.
A provider who focuses on one area of medicine. Like a cardiologist or neurologist
A contracted, pre-determined dollar amount insurance company requires a patient to pay for a particular medical service. (It requires patients to pay a small amount upfront to deter people from seeking medical care that may not be necessary.)
The contracted rate a health insurance company will pay toward a specific medical service.
A contracted, pre-determined percentage of the allowable charge that a patient is required to pay for a particular medical service (after the deductible is met and before the out-of-pocket maximum is met).
A pre-determined annual amount patient must pay before insurance begins to cover.
Annual maximum amount patient is required to pay for in-network medical services per his/her insurance plan contract (typically, copay + coins + deductible)
The person who is responsible for payment of the monthly premium, or whose employment is the basis for the coverage.
A person entitled to health insurance benefits under the subscriber’s plan.
Insurance Company
A specific package of benefits negotiated between the company and the employer.
Dates during which the insurance plan is active.
Explanation of Benefits is a statement from the insurance company that details payments and adjustments made for services. EOBs go to both the provider and the patient.
/Response from the insurance company that states no payment will be made. (service could be not covered by the insurance plan, or the insurance company may need more information.)
The order in which the claim is sent to insurance companies. If patient has more than one insurance plan, we must determine which insurance should be billed primary, secondary, etc. Primary: the first insurance company designated to pay toward their allowable charges. Secondary: the second insurance company designated to pay toward their allowable charges.
The pathway a patient takes from one provider to another. Referrals may be required by insurance before a patient can be seen by the other provider.
The process whereby a physician must obtain insurance approval before a patient receives certain treatment or drugs (study, test, procedure, surgery.)

Medicare 101 Crossword

Medicare 101 Crossword
Type
Crossword
Description

Groups of drugs that have a different cost for each group.
the action you can take if you disagree with a coverage or payment decision made by Medicare, your Medicare health plan, or your Medicare Prescription Drug Plan.
An agreement by your doctor, provider, or supplier to be paid directly by Medicare, to accept the payment amount Medicare approves for the service, and not to bill you for any more than the Medicare deductible and coinsurance.
A geographic area where a health insurance plan accepts members if it limits membership based on where people live.
A coverage rule used by some Medicare Prescription Drug Plans that requires you to try one or more similar, lower cost drugs to treat your condition before the plan will cover the prescribed drug.
A person who has health care insurance through the Medicare or Medicaid programs.
The way that Original Medicare measures your use of hospital and skilled nursing facility (SNF) services.
A written order from your primary care doctor for you to see a specialist or get certain medical services.
A request for payment that you submit to Medicare or other health insurance when you get items and services that you think are covered.
An amount you may be required to pay as your share of the cost for services after you pay any deductibles.
An amount added to your monthly premium for Part B or a Medicare drug plan (Part D) if you don't join when you're first eligible. You pay this higher amount as long as you have Medicare. There are some exceptions.
Approval that you must get from a Medicare drug plan before you fill your prescription in order for the prescription to be covered by your plan.
The amount you must pay for health care or prescriptions before Original Medicare, your prescription drug plan, or your other insurance begins to pay.
A type of Medicare prescription drug coverage determination, a drug plan's decision to cover a drug that's not on its drug list or to waive a coverage rule
A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits.
A complaint about the way your Medicare health plan or Medicare drug plan is giving care.
Health care that you get when you're admitted to a health care facility, like a hospital or skilled nursing facility.
The facilities, providers, and suppliers your health insurer or plan has contracted with to provide health care services.

Patient Access Crossword

Patient Access  Crossword
Type
Crossword
Description

Federal law requiring employers to permit employees to continue their group health insurance coverage after termination
Person who is the holder of an insurance policy
Who rocks
Best boss ever
Conducting ourselves ethically and within the law of business practices
Health Insurance ___ and Accountability Act
Questionnaire to determine primary payor before Medicare
Health Information (PHI - protected by HIPAA)
Payment for insurance coverage
Not to be disclosed
Patient Access Services
Joint Commission on __ of Healthcare Organizations
Master____ Schedule
Type of flower
Avid Coke drinker
Very knowledgeable
Sinus problems
Out____ Crew

Health Insurance Crossword

Health Insurance Crossword
Type
Crossword
Description

A system of health care in which patients agree to visit only certain doctors and hospitals
The acronym for Health Maintenance Organization.
Also known as a primary care physician.
What is the amount you pay for health care services before your health insurance begins to pay?
A sum paid to cover money that has been spent or lost.
A federal law that is sometimes called the "privacy rule".
What type of claim form is used by a hospital?
Meaning of PPO.
Having inadequate insurance coverage.
The insured pays a share of payment made against a claim.
A federal system of health insurance for those requiring financial assistance.
Federal health insurance program for people 65 years or older.
Dental benefits
A payment owed by the person insured at the time a covered service is rendered, covering part of the cost of the service.
Provides health care and financial protection.
M48.1 is an example of what type of code?
Organization paying for some serious treatments people need.
Subscription medical, less restrictive than HMO.
Focus solely on preventative care.
Government pays for all health cost.
Not covered by insurance.
Premium cost and medical expenses by health care plan.

Insurance Word Search

Insurance  Word Search
Type
Word Search
Description

Commercial Insurance Plan
Pharmacy Benefit Manager
Blue Cross Blue Shield
Medical Doctor Office
Medicare Part D Plan
Formulary Exception
Healthcare Provider
Prior Authorization
Specialty Pharmacy
Out of Pocket Max
Registered Nurse
Benefit Cap
Coinsurance
Non Covered
Deductible
Start Form
Provider
Covered
Patient
Dosage
Copay
Payer

Medicare Crossword

Medicare Crossword
Type
Crossword
Description

A federal health insurance program for people over 65, disabled or have End State Renal Disease
Covers inpatient care in hospitals, skilled nursing facilities and some hospice and home health
Covers doctors services, outpatient care, PT/OT and some home health.
Allows private health insurance companies to provide Medicare benefits through HMO's & PPO's
_________________ Plans take the place of original Mediare.
coverage that helps lower prescription drug costs
Beneficiary's Policy number
Beginning _____ 2018, we will see new cards without SSN's
Includes individuals enrolled in Medicare A&B and Medicaid
Dual eligible patients are 65 year old or disabled and ______________
__________ Covers all or part of Medicare co-pays, co-insurance and deductibles for those with dual eligibility
When Medicare does not have primary payment responsibility it is known as Medicare ________ payer.
End Stage Renal Disease
Group Health Plan

Hospital Billing Crossword

Hospital Billing Crossword
Type
Crossword
Description

National Provider Identification
The note received from the insurance company after getting medical services from a doctor or hospital. It tells what was billed, the payment amount approved or denied by the insurance, the amount paid, and what the patient must pay.
Portion of the bill, as defined by the insurance company which the patient owes.
Advanced Beneficiary Notice
A person or persons whose account that has been sent to a collection agency for further action.
The cost sharing part of the bill that the patients have to pay.
A part of the bill that we must write off because of billing agreements with insurance companies.
A cost sharing part of the bill that is the patient’s responsibility to pay.
A coding system used to describe what treatment or services were given to the patient by their provider. Used for hospital outpatient services billed on an UB and professional services billed on HCFA 1500s
How much cost sharing that the patient must pay for medical services often before their insurance starts to pay.
A code used for billing that describes the patient’s condition. Also called ICD-10 diagnosis code.
Individual who is responsibility for the bill.
Patient class in which the patient requires a higher degree of nursing and physician care.
A person who is a policyholder of the insurance. Also known as the subscriber, policyholder, cardholder, or beneficiary.
Type of service used by doctors and hospitals to decide whether a patient needs inpatient hospital care or whether they can recover at home or in an outpatient area. Usually charged by the hour.
Any service received at a hospital or clinic that is not an inpatient status. Includes Emergence Room, Observation, and ancillary services.
A form used by hospitals to file insurance claims for medical services. Used when billing for hospital technical services.
Part of medicare that helps pay for doctor services, outpatient care, and other medical services not paid for by Medicare Part A.
Part of Medicare that usually referred to as Hospital Insurance, it helps pay for inpatient care in hospitals and hospices, as well as some skilled nursing costs.
Claim form used by doctors to file insurance claims for medical services. Used when billing for professional services.
Medicare Secondary Questionnaire
Hospital Billing (abv)
Professional Billing (abv)
After a patient is discharged from, the account status is changes from Open to
Hospital Account
A holding tank for accounts that we have identified has issues or needs follow up performed
Hospital Clinic System used by WVUH