Type
Word Search
Description

This word search contains the following answers:

QUESTIONNAIRE
ACCIDENT RELATED
DISABILITY
COBRA
GROUP HEALTH INSURANCE
BLACK LUNG
PRIMARY
IN LIEU OF
HOSPICE
ESRD
COORDINATION OF BENEFITS

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Medicare Crossword

Type
Crossword
Description

This crossword contains the following questions and answers:

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

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Patient Access Crossword

Type
Crossword
Description

This crossword contains the following questions and answers:

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

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PATIENT ACCESS Crossword

Type
Crossword
Description

This crossword contains the following questions and answers:

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

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Basics of Health Insurance Crossword

Type
Crossword
Description

This crossword contains the following questions and answers:

An established schedule of fees set for services performed by providers and paid by the patient fee for service
protection in return for periodic premium payments that provides reimbursement of expenses resulting from illness or injury Health insurance
the sum of money paid at the time of medical service; it is a form of coinsurance copayment
provision frequently is found in medical insurance policies whereby the policyholder and the insurance company share the cost of covered losses in a specified ratio coinsurance
Civilian Health and Medical Program of the Veterans Administration known as CHAMPUS
states that when an individual is covered under two insurance policies, the insurance plan of the policyholder whose birthday comes first in the calendar year (month and day, not year) becomes the primary insurance. birthday rule
A term used in managed care for an approved referral authorization
a payment method used by many managed care organizations in which a fixed amount of money is reimbursed to the provider for patients enrolled during a specific period of time, no matter what services were received or how many visits were made. Capitation
a letter or statement from Medicare that describes what was paid, denied, or reduced in payment. EOMB
Pays expenses involved in the care of the teeth and gums Dental care
Protects a person in the event of a certain type of accident, such as an airplane crash Special risk insurance
Often includes benefits for medical expenses payable to individuals who are injured in the insured person’s home or during an automobile accident Liability insurance
Covers a continuum of maintenance and health services for chronically ill, disabled, or mentally retarded individuals Vision care
Provides payment of a specified amount on the insured’s death Life insurance
Pays the cost of all or part of the insured person’s hospital room and board and specific hospital services Hospitalization
a review of individual cases by a committee to make sure services are medically necessary and to study how providers use medical care resources utilization review
40. An insurance term used when a primary care provider wants to send a patient to a specialist referral
periodic (monthly, quarterly, or annual) payment of a specific sum of money to an insurance company for which the insurer, in return, agrees to provide certain benefits premium
person who pays a premium to an insurance company and in whose name the policy is written in exchange for the insurance protection provided by a policy of insurance policyholder
a general practice or nonspecialist provider or physician responsible for the care of a patient for some health maintenance organizations gatekeeper

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Patient Access Week Crossword

Type
Crossword
Description

This crossword contains the following questions and answers:

Meeting where coworker issues are resolved Huddle
Federal law requiring employers to permit employees to continue their group health insurance coverage after termination COBRA
Health Insurance _____________and Accountability Act Portability
Cost sharing in which the subscriber is responsible for a specific percentage of the cost of healthcare CoInsurance
(2 words) Tool that utilizes fee schedules, payer contracts, and benefits to calculate a cost estimate Price Estimator
(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 Tax Discount Program
An insurance coverage that doesn't require authorization Medicare
Fixed sum of money that the beneficiary must contribute towards the cost of their healthcare before insurance benefits begin Deductible
The person who is financially responsible for the account Guarantor
Questionnaire to determine primary payor before Medicare MSPQ

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Health/Life Insurance Crossword

Type
Crossword
Description

This crossword contains the following questions and answers:

Medications that have the same composition as their name brand counterparts but are less expensive. Generic
A government plan that requires your employer to allow you to pay to continue your health coverage months after you leave. cobra
A medical condition diagnosed or treated before you join a new insurance plan. preexisting condition
A request from your primary care physician for services from a specialist. referral
Insurace that is designed to replace your lost income when you cannot work because of an accident or illness. disability
The person or persons that receive the death benefit upon your death. beneficiary
An insurance program set up to pay expenses for work-related injuries, illnesses and death. Worker's Compensation
You pay for health services as you receive them. Fee for Service plan
An example would be that you pay the first $500 before coinsurance. Deductible
A managed care plan that charges a set amount for each member each year. (Abbr) hmo
you can usually enroll in your employer's plan when you begin your job or during a specified period each year. openenrollment
Insurance that pays a death benefit if the policyholder dies within a specified period of time. Term

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Insurance Billing/Terminology Crossword

Type
Crossword
Description

This crossword contains the following questions and answers:

The process of establishing the need for a service? medical necessity
A provider's list of charges for services provided. fee schedule
The amount the insurance company determines to be customary price for a service, usually less that what the provider charges? allowed amount
Fixed percentages of the cost of a service paid by the patient or a second insurance? coinsurance
Fixed amount paid by the patient at the time of service? copayment
Payment for health insurance policy? premium
A complete correct claim or a claim with no errors? clean claim
The primary provider who arranges for specialists or hospitalizations? gatekeeper
The medical insurance policy that is billed first? primary policy
National Provider Identification NPI
Centers for Medicare and Medicaid Services CMS
Managed Care Organization MCO
Diagnosis Related Group DRG
Medigap MG
Advance Beneficiary Notice ABN
Coordination of Benefits COB
Primary Care Provider PCP
Fee-For-Service FFS
Common for insurance to require approval for? elective procedures
Used to identify a procedure on a claim form? CPT
Family members of the insured are called? dependents

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Coordination of Benefits Crossword

Type
Crossword
Description

This crossword contains the following questions and answers:

Patient states his BCBS is primary over Medicare. He is ___________. Employed
Not an insurance, but a program offered through healthcare facilities Charity
Another name for employer sponsored coverage GroupHealthPlan
Rule to determine which parent's coverage is primary when legal decree is not in place BIRTHDAY
Replaces Medicare. Only bill this plan Advantage
Birthday rule states the insurance of the parent with a birthday that falls first in the ____ year is primary calendar
patient and spouse are retired with Tricare. Medicare is PRIMARY
Always the insurance payor of last resort Medicaid
Patient is entitled to Veterans Administration benefits. Medicare is Primary because they ____ ___ authorized the services. Havenot
Patient has insurance through current and former employer through Cobra. Which employer plan is primary? current
Patient was in an accident and does not want the auto insurance billed. He has Medicare. Who do we bill first? Liability
Name of plan for commercially insured patients that are injured through an Auto Accident medpay
Mom DOB 5.1.60 has Cigna, Dad DOB 2.1.61 has Tufts, Which plan is primary for dually insured child? Tufts
Patientis active for both Wellsense and Medicaid. Who do we bill? Wellsense
Medicare secondary payor questionaire MSPQ
Coordination of benefits COB

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Patient Access Crossword

Type
Crossword
Description

This crossword contains the following questions and answers:

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

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Medicare 101 Crossword

Type
Crossword
Description

This crossword contains the following questions and answers:

Groups of drugs that have a different cost for each group. Tier
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. Appeal
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. Assignment
A geographic area where a health insurance plan accepts members if it limits membership based on where people live. Service area
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. Step therapy
A person who has health care insurance through the Medicare or Medicaid programs. Beneficiary
The way that Original Medicare measures your use of hospital and skilled nursing facility (SNF) services. Benefit period
A written order from your primary care doctor for you to see a specialist or get certain medical services. Referral
A request for payment that you submit to Medicare or other health insurance when you get items and services that you think are covered. Claim
An amount you may be required to pay as your share of the cost for services after you pay any deductibles. Coinsurance
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. Penalty
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. Prior authorization
The amount you must pay for health care or prescriptions before Original Medicare, your prescription drug plan, or your other insurance begins to pay. Deductible
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 Exception
A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Formulary
A complaint about the way your Medicare health plan or Medicare drug plan is giving care. Grievance
Health care that you get when you're admitted to a health care facility, like a hospital or skilled nursing facility. Inpatient care
The facilities, providers, and suppliers your health insurer or plan has contracted with to provide health care services. Network

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