Medical Billing & Coding: Final Exam Study Guide with Complete Solutions

Medical Billing & Coding: Final Exam Study Guide with Complete Solutions The largest federal program providing healthcare is __________________ which provides health insurance for citizens aged 65 and older as well as certain patients under the age of 65. Medicare The ___________________ ______________ is responsible for filing insurance claims in most medical offices.. Medical Assistant Patients are generally asked to sign an _____________ of _____________statement, in which the provider agrees to prepare healthcare claims for patients, receive payments directly from the payers, and accept a payer's allowed charge. Assignment, Benefits The ______________ may be called the insured, the member, or the subscriber. Policyholder Under an insurance policy, the policyholder pays a __________ or _________________________ for keeping the insurance policy in force. Premium, an annual charge A ___________________ is a fixed dollar amount that must be paid or "met" once a year, in addition to the premium, before the third-party payer begins to cover medical expenses. Deductible A ____________________ is a small, fixed fee collected at the time of the visit from the patients who belong to a managed care health plan. Co-payment In a typical medical practice, claims are transmitted within a few business days ____________ the date of service. After Insurance claims could be denied as a billing error because if the treatment was not medically necessary based on the ____________________ and there is no evidence of code linkage. Diagnosis code In the ____________ for ___________ benefits, the claims department compares the fees the physician has charged with the benefits provided by the patient's health insurance policy to determine the amount of deductible or coinsurance the patient owes. Review, Allowable The total amount the patient owes the practice, including coinsurance, copayment, deductible, and noncovered services, is known as the patients __________________. liability _____________________ insurance covers injuries caused by the insured or that occurred on the insured's property. Liability Although eligibility for Medicare Part B is automatic for people entitled to Medicare Part B coverage is not ______________________. Automatic Medicare Part A is a _______________ benefit for patients who are admitted as inpatients for up to the 90-day benefit period. hospital A Medicare benefit period begins the day a patient is admitted to the hospital and ends when that patient has not been hospitalized or placed in a skilled nursing facility for a period of ________ continuous days after discharge. 60 Medicaid is a health cost _________________ program designed for low-income, blind, or disabled patients. It is not an ______________ program. assistance, insurance Workers of any age who have chronic kidney disease requiring dialysis or end-stage renal disease (ESRD) requiring transplant are eligible for ________________. Medicare ____________ is a short break provided for caregivers to terminally ill patients. The patient is moved to a respite care center or other facility to remove responsibility for care from the caregiver temporarily. Respite