Healthcare Billing Terms and Form Names Quiz by made_of_money

Definition	Term
A code used to charge for procedures performed in an inpatient stay.
A diagnosis-related charge for an outpatient visit. Patients can have multiple groups of these charges.
Codes which charge for the procedures performed in an outpatient setting.
A Medicare policy to determine what is and what is not covered for an encounter. It is based on medical necessity.
A Diagnosis-related charge for inpatient stays. Only one may be assigned to a patient.
A document from the payor explaining what invoices are being paid and why.
System developed my CMS to promote national coding methodologies and reduce duplicate entries
Medicare's identification number it assigns to each claim received to keep track of it.
An electronic request for claim status. Sent by provider to payor.

Definition	Term
Electronic form of remittance advice.
A designation that Medicare gives to qualifying organizations which allows them to bill Medicare on UB and 1500--not just on one CMS form.
Codes which charge for supplies and equipment used in an outpatient setting.
A code that identifies a specific accomodation or service. It is a group of individual charges. Payors will either pay the whole claim, or they'll pay for each of these charges.
Hospital Billing claim in the paper format.
Professional AND Hospital Billing claim in the electronic format.
An electronic response to a request for claim status. Sent from payor back to provider.
Professional Billing claim in the paper format.
Both edit-checks a claim and determines its medium (paper or electronic)

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