Billing and Coding Chapter 1-3

5. / portion of charges an insured person must pay for health care services after a deductible
7. / health plan or program
8. / computerized record of one physicians encounters with a patient
9. / services or care provided to keep patients healthy or prevent illness
11. / process of examining and processing a claim
14. / standards of conduct based on moral principles
15. / order of a court for a party to appear and tesify
16. / company that converts nonstandard transactions and transmits the data to health plans, and reverse procedures
18. / a condition of illness or disorder that existed before teh insurance coverage
21. / computerized lifelong health care record with data from all sources
23. / intentional deceptive act to obtain a benefit
24. / amount teh insured must pay for health care services before health plans payments begin
26. / money the insured pays to health plan for a policy

1. / actions that improperly use anothers resources
2. / person or entity that supplies medical or health services adn bills for, or is paid for, the services in the normal course of business
3. / method of converting a message into encoded text
4. / a rule that determines which parent has the primary insurance for a child
5. / recognition of a superior level of skill by an official organization
6. / actions that satify official requirements
10. / impermissible use or disclosure od PHI
12. / failure to use professional skill when giving medical services that results in injury or harm
13. / person who buys an insurance plan
17. / document signed by a patient to permit release of medical information
19. / office visit between a patient and a medical professionalism
20. / a prepayment covering providers services for a plan member for a specific period
22. / policyholder or guarantor to a health plan
25. / health plan payment for covered services