Domain 6 - Comprehensive exam

What Medicare part pays for regular doctor appointments:

What kind of code is 99252

The payer (insurance) confirms that a patient's coverage will allow a service:

What Medicare part serves as a MAC? (Medicare Advantage contractor)

This is part of the UTILIZATION MANAGEMENT step in the revenue cycle:

What category of coverage is MEDICARE ?

This is a Capitation term. It means a service or procedure is billed & paid separately from another procedure:

You do NOT need this information from a new patient:

Health insurance does not protect against financial losses because of illness or injury

What is a "clearinghouse"?

What kind of code is: J2789

What category of coverage is MEDICAID ?

The US switched to ICD-10-CM on what date?

This shows all the $money$ owed to a doctor or clinic (from patients or insurance)

The payer (insurance) gives an estimate on $reimbursement amount$ for a service

What category of coverage is WORKER's COMPENSATION ?

When patients comes to the medical office, you must ask to see their insurance card - each and every time!

This organization updates the ICD-10-CM coding system every 10 years

ICD-10-CM: a group of codes / descriptors for healthcare procedures & supplies.

Mortality is the rate - or incidence of death - in a specific population

ICD-10-CM does NOT:

This shows a breakdown of debt = by date (owed to the doctor)

"Advance Directive" form: a record that is placed on the appointment schedule

What Medicare part pays for Inpatient services?

What Medicare part pays for basic clinic appointments / office visits?

What category of coverage is an AUTO ACCIDENT ?

This is part of the ADJUDICATION step in the revenue cycle:

What kind of code is: I10

What is included in an accurate, up to date medical record?

What action is part of the CHARGE CAPTURE step of the revenue cycle?

What kind of code is T20.8XXB

What category of coverage is UNITED HEALTHCARE

What kind of code is: 99213

________ developed ICD-10-PCS and only U.S. hospital settings use it.

Morbidity is the number of sickness or disease cases in a population

CPT codes describe....

Incentive payments are issued to doctors for meeting certain required criteria. This is called what?

The payer (insurance) approves the patient's treatment based on medical necessity:

What category of coverage is BC/ BS ?

What category of coverage is SCHIP ?

What Medicare part pays for medication at a pharmacy?