Description

Which form of consent requires to be in writing after an explanation of the procedure?
Which form of consent is assumed?
This refers to the way health information is given to an outside person or organization.
This is the record of clinical observations and care a patient receives at a health care facility.
What refers to reviewing claims for accuracy and completeness
What is the intentional misrepresentation of information for the purposes of receiving higher payments?
What is the unintentional misrepresentation of information due to poor business practices?
What is assigning a code that will deliberately result in a higher payment?
This states that physicians can't refer patients to practitioners with whom they have a financial relationship.
This organization is responsible for fighting fraud.
This is permission granted by the patient to release information.
This is payment for services rendered from a third-party payer.
What is is called when multiple codes are used instead of using a single code that describes all steps of the procedure?
What is an insurance called when it pays first?
What determines which insurance plan is primary and which is secondary?
When a claim is submitted by patients covered by a primary and secondary insurance plan. After the primary insurance pays, it will automatically send the claim to the secondary insurance.
A contract in which the provider directly bills the payer and accepts the allowable charge.
A health plan gives approval for an inpatient hospital stay or a surgical procedure.
What is the fixed amount a provider receives?
A review that looks at whether the procedure could be performed safely but less expensively in an outpatient setting.
A written request for a verification of benefits.
This measures the outstanding balances in each account.
The balance the policyholder must pay to the provider
The difference between the provider's actual charge and the allowable charge.
A form that includes information about past history, current history, inpatient record, discharge information, and insurance information.
This involves reveiwing a health record and translating the medical documentation into specific code sets.

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