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Insurance billing 8/27
30 cards·by cball157
Purpose of advanced beneficiary notice
Notice a provider should give you before you receive service
Examples of our of pocket expenses
Copayment and coinsurance
Primary payer
Insurance carrier responsible for bill
Secondary payer
Secondary insurance
Physical fee schedule
List of fees used by insurance to pay drs
Can providers charge a different amt to each insurance company for same service
False
Is accuracy important when obtained patient info for reimbursement
True
Verification of insurance complete
False
Insurance company contacted to get a managed care referral
False
Is the insurance company contacted to get a pa
True
After transmitting electronic claims do you call the insurance company to make sure they were
received
False
Coordination of benefits
Determining which insurance is the primary
Copayment
Payment due at time of service
NPI
10 diget number assigned by health care providers by CMS
Preauthorization
Prior approval for health care service
Deductible
Specified amount of many that the insured must pay before the insurance will pay
CMS 1500
Paper claim form to bill insurance
Verification of benefits
Determining of a patient is qualified to receive benefits of payments for a service under the
guidelines of the insurance
Medicare
Us government health insurance
Primary care provider
Provider who refers patients to other providers
Medicaid
Federal or state insurance
EDI electronic detecting identifier
Used to submit health care claim billing info
Considered as supporting claim documentation
Chart notes, surgical reports, lab reports
Causes a claim to be rejected
Incorrect info, wrong insurance
Medicare part a
Hospital
Medicare part b
Dr appointments
Medicare part c
Both a and b
Medicare D
Drug benefits
Type of insurance do you have if you are retired military
Tricare
Administers the Medicare program
CMS