Across
- 1. Medical supplies such as wheelchairs, oxygen, catheter, glucose monitors, crutches, walkers, etc., meant for long term use.
- 3. Gives authority to act on behalf of the patient in specific matters. Null and void at death.
- 7. A nursing home or facility for convalescence. Provides a high level of specialized care for long-term or acutely ill patients. A Skilled Nursing Facility is an alternative to an extended hospital stay or home nursing care.
- 11. A procedure not covered by the patient’s health insurance plan.
- 16. Patient/guarantor designates a relative or friend as someone treating health entities can release PHI to the event that someone should need to contact us on their behalf.
- 18. An individual appointed to administer the estate of a deceased patient. Executor will notify creditors of the patient’s death and use the funds (if any) to pay off outstanding debts.
- 22. The amount a patient is responsible for paying that is not covered by the insurance plan. Deductible (PR1), Coinsurance (PR2), Copays (PR3), and Non-covered Charges.
- 23. Also known as Employer Identification Number (EIN).
- 24. Typically, treatment in a physician’s office, clinic, or day surgery facility that lasts less than one day.
- 27. Inpatient, outpatient, or home healthcare for terminally ill patients.
- 29. Medicare supplemental health insurance for Medicare beneficiaries which may include payment of Medicare deductibles, co-insurance and balance bills, or other services not covered by Medicare.
- 30. Number assigned by insurance company to identify the group under which a patient is insured.
- 33. Insurance claim that results from a work-related injury or illness.
- 34. Insurance coverage for low-income patients. Funded by Federal and state government and administered by states.
- 37. Any drugs a patient can take or consume themselves (oral, topical, injectable or via eye drop).
Down
- 2. Hospital stay for more than one day (24 hours).
- 4. Authorizes treating health entities to release PHI to another entity such as attorneys.
- 5. The process of identifying disease, condition, or injury by examining a person’s signs and symptoms.
- 6. Insurance provided by the federal government for people over 65 or people under 65 with certain restrictions.
- 8. Date that health care services were provided.
- 9. Medical claim submitted after the time limit allowed by the insurance payer. Claims submitted after this date are denied.
- 10. One of the medical billing terms for the statement that comes with the insurance company payment to the provider (and patient) explaining payment details, covered charges, write offs, and patient responsibilities and deductibles.
- 12. Outpatient medical care for acute health issues that are too severe to wait for a primary care appointment, but not dangerous enough for an emergency room (ER).
- 13. An individual or entity legally and financially responsible for paying any medical expenses not covered by insurance.
- 14. Requirement of insurance plan for primary care doctor to notify the patient insurance carrier of certain medical procedures (such as outpatient surgery) for those procedures to be considered a covered expense.
- 15. Medical service or procedure that is performed for treatment of an illness or injury that is not considered investigational, cosmetic, or experimental.
- 17. Abbreviation for Date of Birth.
- 19. This is federal health insurance for active-duty military, National Guard and Reserve, retirees, their families, and survivors. Formerly known as CHAMPUS.
- 20. Typically reference to the difference between what the physician charges and what the insurance plan contractually allows, and the patient is not responsible for. May also be referred to as "not covered" in some glossary of billing terms.
- 21. The amount patient must pay before insurance coverage begins. For example, a patient could have a $1000 deductible per year before their health insurance will begin paying. This could take several doctor's visits or prescriptions to reach the deductible.
- 25. A detailed, line-by-line financial document that lists every individual service, procedure, test, medication, and supply provided during a medical visit, rather than showing only a single lump-sum total. This may be used to submit for reimbursement from an HSA or FSA provider.
- 26. A list of prescription drug costs for which an insurance company will provide reimbursement.
- 28. Amount paid by patient at each visit as defined by the insured plan.
- 31. When one provider (usually a family doctor) refers a patient to another provider (typically a specialist).
- 32. A unique 10-digit identification number required by HIPAA and assigned through the National Plan and Provider Enumeration System (NPPES).
- 35. Current Procedural Terminology. This is a 5-digit code assigned for reporting a procedure performed by the physician. The CPT has a corresponding ICD-9 diagnosis code. (Established by the American Medical Association.)
- 36. Name, Address, DOB, SSN, Insurance etc.