Happy Customer Service Week!

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Across
  1. 2. Necessity, the requirement that a service is appropriate and needed for the patient’s condition.
  2. 3. Plan, an arrangement that allows a patient to pay a medical balance over time.
  3. 5. the process of collecting a patient’s demographic, insurance, and billing information.
  4. 7. using a code that represents a more expensive or complex service than what was actually provided.
  5. 10. an insurance company or organization responsible for paying a claim.
  6. 13. a statement from insurance explaining how a claim was processed and paid.
  7. 15. of Benefits, determining which insurance plan pays first when a patient has multiple plans.
  8. 17. approval from an insurance company before certain medical services are performed.
  9. 19. a request asking the insurance company to reconsider a denied claim.
  10. 20. information showing how an insurance payment was applied to a claim.
  11. 22. Balance, money remaining on an account because payments were greater than the amount owed.
  12. 24. Error, incorrect or missing information on a medical code that can affect claim payment.
  13. 25. money returned to a patient or insurance company because of an overpayment.
  14. 26. checking whether a patient’s insurance is active and covers their services.
  15. 30. the medical condition or reason a patient received care.
  16. 31. a claim that an insurance company refuses to pay.
  17. 32. a balance the patient is responsible for paying without insurance coverage.
Down
  1. 1. an amount removed from a balance that the provider does not expect to collect.
  2. 3. a medical service or treatment performed on a patient.
  3. 4. a change made to the amount owed because of insurance rules, contracts, or corrections.
  4. 6. Receivable, money a healthcare provider is owed for services already provided.
  5. 8. a healthcare professional or facility that provides medical services.
  6. 9. Insurance, an additional insurance plan that may pay remaining eligible charges after the primary insurance.
  7. 11. approval from an insurance company before certain medical services are performed.
  8. 12. the person financially responsible for a patient’s medical bill.
  9. 14. an electronic payment and explanation showing how an insurance claim was processed.
  10. 15. the process of verifying and approving a provider to participate with an insurance plan.
  11. 16. the amount of time a medical balance or claim has remained unpaid.
  12. 18. changing a submitted code to one representing a lower level of service or payment.
  13. 21. codes used to describe medical procedures and services performed. HCPCS, codes used for medical services, supplies, medications, and equipment.
  14. 23. Balance, the amount a patient is responsible for paying after insurance processes the claim.
  15. 24. a bill submitted to an insurance company for payment.
  16. 27. Filing, the deadline for submitting a claim to an insurance company.
  17. 28. the amount billed by the provider for a medical service.
  18. 29. a code added to a procedure code to provide additional details about the service.