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