UHI week 2

4. A practice of third-party payers in which the benefits code has been changed to a less complex or lower cost procedure than was reported
6. The name adopted in October 2001 by the agency formerly known as the Health Care Financing Administration (HCFA)
11. Document used to record the services provided to a patient; also known as a superbill
12. To pay back or compensate for money spent, or losses or damages incurred
13. Reporting a higher level code than is appropriate for the service that was rendered resulting in higher reimbursement
14. Exists when a patient is covered under more than one insurance plan; charges are first submitted to the primary carrier and any charges not covered are then submitted to the secondary carrier
17. Provide forward and backward mapping between the ICD-9 and ICD-10 coding systems
19. Computer software designed for monitoring insurance claims.
20. Something specially suited for a given use or purpose; a remedy regarded as a certain cure for a particular disease; most specific

1. Payment made by a party other than the one providing or receiving the service, such as a physician or patient
2. Reporting multiple codes for a service when there is one code that will report the entire service
3. A form explaining which benefits have and have not been paid.
5. The major factors to be considered when selecting an Evaluation and Management code: history, exam, medical decision making
6. The insurance company providing coverage under a specific plan
7. The rule that requires the reason for a patient's visit to be coded first
8. The main reason a patient is seen or cared for during an encounter
9. Record of all transactions made on an individual's financial record that lists debits, credits, and balance
10. Services or supplies that are needed for the diagnosis or treatment of your medical condition and meet accepted standards of medical practice
15. Arranged in order
16. A two-digit numerical code applied to the five-digit Current Procedural Terminology (CPT) code to indicate unusual procedural services
18. The name of the standard unique health identifier for health care providers