Midterm Review

Question 0

Respondeat superior

Answer 0

“Let the master answer”

Question 1

EOB/remittance advice

Answer 1

Statement describing payment to physician from insurance.

Question 2

Medical malpractice insurance

Answer 2

Liability insurance

Question 3

Deductible

Answer 3

Amount patient pays before insurance pays

Question 4

Co-payment

Answer 4

Fixed amount the patient must pay at each visit.

Question 5

Respipsaloquitor

Answer 5

” it speaks for itself”

Question 6

Super bill

Answer 6

Charge slip

Question 7

Guarantor

Answer 7

Person financially responsible for a bill

Question 8

Beneficiary

Answer 8

One who holds the policy

Ie: Dad is the beneficiary on the insurance.

Question 9

Medicare and Medicaid are both

Answer 9

federal programs ran by the state

Question 10

Policy holder is also known as

Answer 10

Subscriber or member

Question 11

Patient ledger

Answer 11

Financial statement

Question 12

CMS 1500

Answer 12

Universal health form

Question 13

PHI

Answer 13

Privileged and non privileged information.

Question 14

4 parts of Medicare are

Answer 14

1. Hospital coverage
2. Dr.’s office
3. HMO
4. Rx(prescriptions)

Question 15

Emancipated minor

Answer 15

Person younger than 18 with rights of an adult.

Question 16

Birthday rule

Answer 16

Parent closest to January.

Question 17

HIPAA I

Answer 17

Protects health insurance coverage for workers and their families when you change or lose their jobs.

Question 18

HIPAA II

Answer 18

Addresses the security and privacy of health data.

Question 19

Confidentially violation has to be reported to

Answer 19

Police or board of health.

Question 20

Dirty claim

Answer 20

An insurance form submitted with errors.

Question 21

JCAHO

Answer 21

Joint commission on the accreditation of healthcare organizations:

Private, non-profit organization who’s mission is to continuously improve the safety and quality of public health care.

Question 22

Ethics

Answer 22

Morals

Question 23

Etiquette

Answer 23

Manners

Question 24

Workers compensation insurance

Answer 24

Insurance provided by the employer in the event someone gets hurt on the job.

Question 25

CHAMPVA

Answer 25

Covers disabled veterans and their family

Question 26

Tricare

Answer 26

Covers active military personnel and their family.

Question 27

CLIA

Answer 27

Clinical laboratory improvement amendment:

Laboratory that performs testing on materials derived from human bodies for the purpose of providing information for the diagnoses, prevention, or treatment of any disease.

Question 28

OIG

Answer 28

Office of inspector general:

Responsible for Medicare and Medicaid fraud.

Question 29

Fraud

Answer 29

Intended

Question 30

Abuse

Answer 30

Accidental

Question 31

Demographics

Answer 31

Patient’s information

Example: age, sex, race, etc.

Question 32

Co-insurance

Answer 32

Secondary insurance