Week 1 Core

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Across
  1. 7. Diagnosis, procedure code, referring physician, place of service, date of service
  2. 8. Payer edits
  3. 9. Process of determining outcome of claim
  4. 12. Protects the employee in a self-funded plan
  5. 13. Provider
  6. 15. Quadax Internal Check
  7. 17. What was done to treat the patient
  8. 18. Unlisted code
  9. 19. In patient claim form
Down
  1. 1. Adjudicates the claim Provides reimbursement Assumes risk for claim payment
  2. 2. Electronic or hardcopy
  3. 3. number Charges and demographics are matched up in HARP by this
  4. 4. Special processes in PAS that happen BEFORE the claim is generated and sent to insurance co
  5. 5. Employer Network TPA
  6. 6. Patient name, DOB, address, insurance information, phone number
  7. 10. What the Dr. states is the reason the patient came to be seen
  8. 11. Demos and Charges create a __________
  9. 14. International Classification of Diseases
  10. 16. Out patient claim form
  11. 19. Current Procedural Terminology