Exam (elaborations)
(ME2550) Healthcare Settings, Claim Cycle, and Claims Processing ME2550_Week_3_Assignment_D
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- Ultimate Medical Academy
(ME2550) Healthcare Settings, Claim Cycle, and Claims Processing
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1. Match the following medical term with the corresponding billing rule.Answe Billing Rule Terms
r
1 Varies according to BCBS plan, with some plans having none for 1. Deductible
preventative medicine services.
4 Customarily one year from the date of service, unless otherwise 2. Coinsurance
specified in the subscriber’s or provider’s contracts
2 Typically, 20-25% patient out of pocket expense per visit for non- 3. Assignment of Benefits
preventative services.
5 Document sent by insurance to providers to explain claim 4. Claim filing deadline
reimbursement, that includes patient applicable deductible,
copayment and coinsurance expense responsibility for each claim
processed.
3 Allows payment to be made directly to the provider by BCBS. 5. Remittance Advice
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