Financial Management

Front 1

A bed patient in a hospital is called__________.

Back 1

inpatient

Front 2

A person who represents either party of an insurance claim is the __________.

Back 2

adjuster

Front 3

A request for payment under an insurance contractor bond is called a

Back 3

claim

Front 4

Payment made periodically to keep an insurance policy in force is called ________.

Back 4

premium

Front 5

A person or institution that gives medical care is a __________.

Back 5

provider

Front 6

Benefits that are made in the form of cash payments are known as__________.

Back 6

indemnities

Front 7

An amount the insured must pay before policy benefits begins is called

Back 7

deductible

Front 8

An organization that offers health insurance at a fixed monthly premium with
little or no deductible and works through a primary care provider is called

Back 8

health maintenance organization

Front 9

Health insurance that provides protection against the high cost of treating severe
or lengthy illnesses or disabilities is called

Back 9

catastrophic

Front 10

A patient receiving ambulatory care at a hospital or other health facility without
being admitted as a bed patient is called an

Back 10

outpatient

Front 11

An injury that prevents a worker from performing one or more of the regular
functions of his or her job would be known as a

Back 11

partial disability

Front 12

A previous injury, disease or physical condition that existed before the health
insurance policy was issued is called

Back 12

preexisting condition

Front 13

One who belongs to a group insurance plan is called

Back 13

subscriber

Front 14

A sum of money provided in an insurance policy, payable for covered services is
called

Back 14

benefits

Front 15

To prevent the insured from receiving a duplicate payment for losses under more
than one insurance policy is called

Back 15

coordination of benefits

Front 16

When a patient has health insurance, the percentage if covered services that is the responsibility of the patient to pay is known as

Back 16

coinsurance

Front 17

Insurance that is meant to offset medical expenses resulting from a catastrophic
illness is called

Back 17

major medical

Front 18

An unexpected event which may cause injury is called

Back 18

accident

Front 19

A doctor who agrees to accept an insurance companies pre-established fee as the maximum amount to be collected is called

Back 19

participating physician

Front 20

Insurance plans that pay a physician’s full charge if it does not exceed his normal
charge or does not exceed the amount normally charged for the service is called

Back 20

usual, customary and reasonable

Front 21

A notice of insurance claim or proof of loss must be filed within a designated ________or it can be denied

Back 21

time limit

Front 22

A health program for people age 65 and older under social security is called

Back 22

Medicare

Front 23

A civilian health and medical program of the uniform services is called .

Back 23

Tri-Care

Front 24

A form of insurance paid by the employer providing cash benefits to workers
injured or disabled in the course of employment is called

Back 24

Worker’s
Compensation

Front 25

A recap sheet that accompanies Medicare or Medicaid check, showing the
breakdown and explanation of payment on a claim is called

Back 25

explanation of benefits

Front 26

A type of insurance whereby the insured pays a specific amount per unit of service
and the insurance pays the rest of the cost is called

Back 26

co-payment

Front 27

In insurance, greater coverage of diseases or an accident, and greater indemnity
payment in comparison with a limited clause is called

Back 27

comprehensive

Front 28

A rider added to a policy to provide additional benefits for certain conditions is
called

Back 28

dread disease rider

Front 29

An interval after a payment is due to the insurance company in which the policy
holder may make payments, and still the policy remains in effect is called

Back 29

grace period

Front 30

An agreement by which a patient assigns to another party the right to receive
payment from a third party for the service the patient has received is called

Back 30

assignment of benefits

Front 31

A skilled nursing facility for patients receiving specialized care after discharge from
a hospital is called

Back 31

extended care facility

Front 32

Payment for hospital charges incurred by an insured person because of injury or
illness is called

Back 32

hospital benefits

Front 33

An agent of an insurance company who solicits or initiates contracts for insurance
coverage and services, and is the policyholder for the insurer is called

Back 33

insurance agent

Front 34

A method of charging whereby a physician presents a bill for each service
rendered is called

Back 34

fee-for-service

Front 35

The Tri-Care fiscal year is from

Back 35

October 1 to September 30.

Front 36

The number on the Employees Withholding Exemption Certificate is

Back 36

W-4

Front 37

FICA provides benefits for

Back 37

social security

Front 38

As part of the office bookkeeping procedures, the physician’s bank account should be reconciled with the

Back 38

checkbook

Front 39

A record of debits, credits, and balances is referred to as a patient’s

Back 39

ledger

Front 40

A signature on the reverse side of a check is called

Back 40

endorsement

Front 41

A form to itemize deposits made to savings or checking accounts is called_________.

Back 41

deposit slip

Front 42

To correct a handwritten error in a patient’s chart it is only acceptable to

Back 42

draw a line through the error, insert the correct information, date and initial it.

Front 43

Low income patients can be covered by

Back 43

Medicaid

Front 44

The reference procedural code book that uses a numbering system developed by the AMA is called a

Back 44

current procedural terminology.

Front 45

____________is a method used for determining whether a particular service or procedure is covered under a patient’s policy

Back 45

Pre-certification

Front 46

The International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) is used to code

Back 46

diagnoses.

Front 47

In insurance coding using an “E” designates

Back 47

classification of environmental
events, such as poisoning

Front 48

E/M codes are located in the _____ manual

Back 48

CPT

Front 49

codes can modifiers be added to, to indicate that a procedure or service has
been altered.

Back 49

CPT

Front 50

The _________form is used by non-institutional providers and suppliers to bill
Medicare, Part B covered services.

Back 50

CMS-1500