Billing Terms Crossword

Assignment of benefits
Authorization by the policyholder the allows a payer to pay benefits directly to a provider.
A patient who has not received professional services from a provider or another provider in the same practice with the same speciality in the past three years.
the insurance plan that pays benefits after payment by the primary payer when a patient is covered by the more than one medical insurance plan.
Form used to summarize the treatments and services patients received during visits.
A patient who has received professional services form a provider or another provider in the same practice with the same speciality in the past three years
policyholder, guarantor, or subscriber
A claused in an insurance policy that explains how the policy will pay if more than one insurance policy applies to the claim.
The insurance plan that pays benefits first when a patient is covered by the two medical insurance plans.
Form completed by patients that summarizes their demographics and insurance information.
a policy retaining patients credit card information
the document a patient signs to guarantee payment when a referral authorization is pending.
the number assigned to a HIPAA 270 electronic transaction
A payment made during checkout based on an estimate
If a health plan member receives medical services from a provider who does not participate in the plan cost to the member is
If a husband has an insurance policy but is also eligible for benefits as a dependent under his wife's insurance policy, the wifes policy is considered ______ for him.
A practice’s rules for payments for medical services are found in its
The encounter form is a source of _____ information for the medical insurance specialist
Under Medicare, what must a provider receive before it is permitted to collect a deductible or any other payment ?
objective evidence of a disease or condition
subjective, as related by the patient
Changed a code from the accurate one to one that you know the insurance company will pay for.
Coding each individual procedure if there is a code that includes all of those procedures in ONE code.
Choosing a higher level code than what was actually done just to get more money from the insurance company.
Billing for something that was not documented in the patient’s chart.
cause or underlying condition
effects of a condition
A set of 5 digit codes used to describe all medical services which are performed.
A set of codes used to identify what is wrong with a patient –their diagnosis-or why the patient received medical services.
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996