FREE Medical Insurance Billing Question and Answers
To properly code in the section, you will need to be familiar with the information in these.
Explanation:
For you to correctly code in the part, guidelines contain information that you must understand.
A(n)_______________ is a person or organization that provides medical care.
Explanation:
The hospital serves as the provider under the framework of provider-based billing, which is carried out by primary providers. Any provider who establishes or acquires control of a different site in order to offer additional healthcare services is referred to be a major provider by Medicare.
A periodic payment made to keep an insurance coverage active is referred to as ________.
Explanation:
The cost paid by the policy holder to the health insurance company that entitles them to the benefits under the health insurance policy is known as an insurance premium. The insurance premium is typically paid once a year, however, depending on the agreement between the insurer and policy holder, it may also be paid monthly or daily.
A(n)_______________ is the name of a company that provides health insurance for a set monthly cost with little to no deductible and through a primary care physician.
Explanation:
A network or organization that offers health insurance coverage in exchange for a monthly or yearly charge is known as a health maintenance organization (HMO). An HMO is a collection of health insurance companies that restricts coverage to medical services delivered by physicians and other providers who have agreements with the HMO.
The_________________ is the person who speaks on behalf of either party in an insurance claim.
Explanation:
To gather and handle claims, these adjusters work directly with the healthcare provider. They accomplish this by collaborating with the patient to complete the claims paperwork, which they subsequently deliver to the insurance company.
An amount that the insured must pay before receiving policy benefits is referred to as _________.
Explanation:
The amount that policyholders must pay up front before their insurance policies begin to pay for a bigger share of their medical expenses is known as the deductible. Policyholders are required to pay lower premiums with a higher copay amount.
A(n)_______________ is the name of the request for payment made under an insurance contractor bond.
Explanation:
A medical claim is a bill for services done that the doctor sends to the patient's health plan. Medical billing claims preparation entails converting patient interactions into precise, timely bills, submitting them to payers, and keeping an eye on adjudication to make sure they are completely paid.