Miscellaneous Quiz / Healthcare Billing Terms and Form Names

Random Miscellaneous Quiz

Can you name the Healthcare Billing Terms and Form Names?

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An electronic request for claim status. Sent by provider to payor.
A document from the payor explaining what invoices are being paid and why.
A diagnosis-related charge for an outpatient visit. Patients can have multiple groups of these charges.
Professional Billing claim in the paper format.
A code used to charge for procedures performed in an inpatient stay.
System developed my CMS to promote national coding methodologies and reduce duplicate entries
Hospital Billing claim in the paper format.
Medicare's identification number it assigns to each claim received to keep track of it.
Codes which charge for the procedures performed 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.
Professional AND Hospital Billing claim in the electronic format.
A designation that Medicare gives to qualifying organizations which allows them to bill Medicare on UB and 1500--not just on one CMS form.
A Medicare policy to determine what is and what is not covered for an encounter. It is based on medical necessity.
Electronic form of remittance advice.
Codes which charge for supplies and equipment used in an outpatient setting.
Both edit-checks a claim and determines its medium (paper or electronic)
An electronic response to a request for claim status. Sent from payor back to provider.
A Diagnosis-related charge for inpatient stays. Only one may be assigned to a patient.

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