OTEC 1175 Unit 2 Terminology

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Across
  1. 3. Patients sometimes have more than one insurance company; the PRIMARY insurance is the main insurance. If a patient has two insurance coverage it is known as dual coverage.
  2. 6. Out-of-pocket expense that patient must pay before the insurance company will pay for covered services. Usually begins at the beginning of the year January 1.
  3. 7. Agrees to provide medical services to specific patient populations and negotiates for reimbursement under contract.
  4. 10. A health plan, health care clearinghouse (such as billing services), or a physician or hospital that transmits health information to electronic form.
  5. 11. Some insurance plans pay a percentage of an approve amount of the fees after the deductible has been paid.
  6. 12. A short collections note that appears on the bill; most patient billing systems include this feature.
  7. 14. Covered entities can share protected health information (PHI) with business associated ONLY with written assurance from the association that the information will be appropriately safeguarded.
  8. 17. International Classification of Diseases codes used to identify patients diagnosis.
  9. 18. 24-hour hospital stay
  10. 19. A service that facilitates the movement of electronic claims from the medical office to the insurance companies. The claims are edited and validated to ensure accuracy.
  11. 20. Additional office locations that are part of the same practice or business entity.
Down
  1. 1. A manage care plan that requires a fixed payment at each office visit.
  2. 2. Organizations that combine the delivery of health care and reimbursement for services in order to control costs and manage access to health care.
  3. 4. 1996 Protection of patient health information. Ensures that individuals have an opportunity to keep their health insurance when they leave an employer. Major focus is on security and privacy of health information.
  4. 5. Amounts that are taken away from (or added to) the balance of an account. Adjustment are often used to reflect accounting situations.
  5. 7. Privacy rules apply to health information that can be individually identified in any form: orally, on paper, or electronically.
  6. 8. Source document that include the notes written in the patient’s record also known as Encounter form, charge ticket, fee slip or visit slip.
  7. 9. Services not covered by a health plan.
  8. 13. Current Procedural Terminology Codes that identify procedures performed for patients.
  9. 15. Patients receive monthly billing statements if balances are due. This serves as a reminder that they owe.
  10. 16. The person responsible for paying medical expenses, usually the patient.