Across
- 1. ___ Contractor = defined by the ’Lectric Law Library’s Lexicon as “a person who performs services for another under an express or implied agreement and who is not subject to the other’s control, or right to control, of the manner and means of performing the services. The organization that hires an independent contractor is not liable for the acts or omissions of the independent contractor.”
- 6. professional association, previously known as the American Academy of Professional Coders, established to provide a national certification and credentialing process, to support the national and local membership by providing educational products and opportunities to networks, and to increase and promote national recognition and awareness of professional coding.
- 8. the illegal transfer of money or property as a fraudulent action; to steal money from an employer.
- 13. ___ Superior = Latin for “let the master answer”; legal doctrine holding that the employer is liable for the actions and omissions of employees performed and committed within the scope of their employment.
- 15. Centers for Medicare and Medicaid Services = formerly known as the Health Care Financing Administration (HCFA); an administrative agency within the federal Department of Health and Human Services (DHHS).
- 17. ___ Specialist = see health insurance specialist.
- 18. Health Insurance ___ = documentation that is electronically or manually submitted to an insurance plan requesting reimbursement for health care procedures and services provided (e.g., CMS-1500 and UB-04 claims).
- 22. ___ Insurance = protects business contents (e.g., buildings and equipment) against fire, theft, and other risks.
- 23. Medical ___ Insurance = a type of liability insurance that covers physicians and other health care professionals for liability claims arising from patient treatment.
- 24. principle of right or good conduct; rules that govern the conduct of members of a profession.
- 26. American Health Information Management Association = founded in 1928 to improve the quality of medical records, and currently advances the health information management (HIM) profession toward an electronic and global environment, including implementation of ICD-10-CM and ICD-10-PCS in 2013.
- 27. American Association of Medical Assistants = enables medical assisting professionals to enhance and demonstrate the knowledge, skills, and professionalism required by employers and patients; as well as protect medical assistants’ right to practice.
- 28. ___ Compensation Insurance = insurance program, mandated by federal and state governments, that requires employers to cover medical expenses and loss of wages for workers who are injured on the job or who have developed job-related disorders.
Down
- 2. ___ and Omissions Insurance = see professional liability insurance.
- 3. Hold ___ Clause = policy that the patient is not responsible for paying what the insurance plan denies.
- 4. Health ___ Technician = professionals who manage patient health information and medical records, administer computer information systems, and code diagnoses and procedures for health care services provided to patients.
- 5. conduct or qualities that characterize a professional person.
- 7. Medical ___ = involves linking every procedure or service code reported on an insurance claim to a condition code (e.g., disease, injury, sign, symptom, other reason for encounter) that justifies the need to perform that procedure or service.
- 9. nonpaid professional practice experience that benefits students and facilities that accept students for placement; students receive on-the-job experience prior to graduation, and the internship assists them in obtaining permanent employment.
- 10. ____ Insurance = an insurance agreement that guarantees repayment for financial losses resulting from the act or failure to act of an employee. It protects the financial operations of the employer.
- 11. Business ___ Insurance = protects business assets and covers the cost of lawsuits resulting from bodily injury, personal injury, and false advertising.
- 12. ___ Coding = process of reporting diagnoses, procedures, services, and supplies as numeric and alphanumeric characters (called codes) on the insurance claim.
- 14. Medical ___ = employed by a provider to perform administrative and clinical tasks that keep the office or clinic running smoothly.
- 16. ___ of Practice = health care services, determined by the state, that an NP and PA can perform.
- 19. ___ Liability Insurance = provides protection from liability as a result of errors and omissions when performing their professional services; also called errors and omissions insurance.
- 20. Health Insurance ___ = person who reviews health-related claims to match medical necessity to procedures or services performed before payment (reimbursement) is made to the provider; see also reimbursement specialist.
- 21. Health Care ___ = physician or other health care practitioner (e.g., physician’s assistant).
- 25. ___ Examiner = employed by third-party payers to review health-related claims to determine whether the charges are reasonable and medically necessary based on the patient’s diagnosis.