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53 Cards in this Set
- Front
- Back
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Accounts receivable
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Money that is owed to a practice, money coming in, entire group of patient ledgers ,
money patients owe to practice. |
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Assignment of benefits
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An arrangement by the patient to send payment directly to the physician
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When do encounter begin
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On the telephone
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Which age group will be doubling over the next 30 years
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The volume of eldery will double the people ages 65 and over
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One write or pegboard system
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Captures info at the time of the transaction
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Backup files
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Must have just in case power surge occurs
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Payroll ledger
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Separate record for wages and salaries
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Collection agency
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Organization that collects money that is owed
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Patient ledger card
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A chronicalogical accounting of particular patient activities including all charges and payments
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Billing cycle
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statements are mailed periodically usually every 30 days
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Causes of claim rejection
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ID incorrect, missing EIN #, wrong codes
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Daily Journal
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Chronological record of all patient transactions, including previous balances, charges, payments, and current balance
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Defendant
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The party being sued
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Disbursements journal
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A listing of all expenses paid out to vendors, such as building rent, office supplies, and salaries
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Federal Truth in Lending Act 1968
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The credit is subject to a finance charge or must be paid in more than 4 installments according to a written agreement
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It's human nature to
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Want to like their doctor
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Fair Debt Collection Practices Act
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Addresses abusive methods used by third-party collectors.
collectors hired to collect overdue bills |
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Copy
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Both sides of the patient insurance card
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General ledger
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most basic of journals, a chronological listing of transactions.
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surrogates
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Substitutes for intangible services , E. G patient looks at the bathroom, offices, and secretary
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Five categories of problems debtors
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something else came up , chronically slow, can't pay, forgetful , fradulent Debtors
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Patient information form
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Patient demographics, address, phone number, and health insurance information
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Plaintiff
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Person who is bringing a lawsuit
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Release of information
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Must have a sign release of information before you send it out
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Services that need pre authorization
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Inpatient authorization , new patient procedures, and diagnostic
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Approach the patient if
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They don't fill out the health insurance information
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Never assume that the patient who pays cash
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Won't pay their bills
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When does the first encounter usually happen with the patient
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When they call
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Process of reviewing a claim and making payment decision is called
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Adjudication
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A good method for small offices to record accounting is
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One-write/ pegboard /write it once system
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If patient has no insurance listed what should you do
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Asked why
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Regulation z has how many installments
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4
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A columnar form used to record claims information
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Insurance claims register
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If you are sending a corrected claim for reconsideration what should it state
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corrected bill not A duplicate claim
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Money patient's owe Practice
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Accounts receivable
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What is a billing cycle
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When the periodic statements are sent out
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What must be included on each attachment of a paper claim
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Practice name, group number, provider, address, phone number
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What is the average allow time to submit a claim
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1 year
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What is the collective name of the third party collector
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Collection agency
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In small claims who mustseek other remedies before the suit
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Plaintiff
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First level of Medicare appeal
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Request for review
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How can you request a fair hearing
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On record , telephone hearing, personal hearing
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Most productive type of hearing is
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Hearing on record
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9 digit tax ID number
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EIN/ employer identification number
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What information must be present for Medicare to review a claim
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Date of initial determination, beneficiary name and Medicare number, item, service being appealed
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E 0 B is also called
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remittance advice
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Core of the financial records
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General ledger
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If using electronic billing software what is done to prevent loss due to power outages
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periodic backup
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If you feel the claim was wrongfully denied
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File an appeal
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What is in block 11d on the CMS 1500
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Is the secondary insurance
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If a married couple both have insurance are they managed
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Coordination of benefits
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What is EOB
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Explains how the claim was adjucated
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What is ROI
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Release of information must have signed ROA before information can be sent out
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