What does the acronym PPO stand for?
Preferred Provider Organization
What is the acronym for Health Maintenance Organization?
HMO
There are two types of medical billing: Institutional and _______________________.
Professional
An __________ is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf.
EOB
What type of claim form is used by hospitals?
UB-04
Another name for a Health Information Specialist is a _________________________ Specialist.
Reimbursement
An _____________________________ is a digital version of the traditional paper-based medical record for an individual. The EMR represents a medical record within a single facility, such as a doctor's office or a clinic.
EMR
What is the amount you pay for health care services before your health insurance begins to pay?
Deductible
A __________ is a fixed amount you pay for a health care service?
Copay
A primary care physician is also known as a _______________________.
Gatekeeper
What is the abbreviation for out-of-network?
OON
What is the abbreviation for in-network?
INN
What type of managed care plan lets you choose between an HMO or a PPO each time you need care?
POS
How many parts does Medicare have?
Four
A 1996 federal law that is sometimes called the "privacy rule", outlining how certain entities can use or disclose personal health information.
HIPAA
The reason for the visit or surgery that defines the disease process or injury.
Medical Necessity
M48.1 is an example of what type of code?
ICD-10
What does UB stand for in UB-04?
Uniform Bill
The healthcare system, funded by the U.S. Department of Defense, that active and retired military and their dependents use.
Tricare
The entity that reimburses the provider for services. Insurance companies, Medicare, Medicaid, and third-party administrators are all payers in the healthcare industry.
Payer
Any health care plan, provider, or service that transmits health care information in an electronic form and is thereby governed by laws and regulations in the handling of such data. It's called a covered _______________?
Entity

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