HCCA CHC - Enterprise Wide Billing And Reimburseme
HCCA CHC - Enterprise Wide Billing and Reimburseme
Exam (elaborations)
HCCA CHC - Enterprise Wide Billing and Reimbursement Questions and Answers with complete solutions
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Course
HCCA CHC - Enterprise Wide Billing and Reimburseme
Institution
HCCA CHC - Enterprise Wide Billing And Reimburseme
Medicare - Part C Insurance (Medicare Advantage) - Government managed care. Must be paying
Part B Premiums to qualify.
Def: Medicare Code Editor - As san electronic claim is being processed, it goes through the editor
for accuracy.
CMS 1500 Paper Billing Form/837P Electronic Billing Form - Used...
HCCA CHC - Enterprise Wide Billing and
Reimbursement
Medicare - Part C Insurance (Medicare Advantage) - Government managed care. Must be paying
Part B Premiums to qualify.
Def: Medicare Code Editor - As san electronic claim is being processed, it goes through the editor
for accuracy.
CMS 1500 Paper Billing Form/837P Electronic Billing Form - Used by Physicians to bill
Def: Carrier - Part B, administers MD claims
Def: Certificate of Medical Necessity - MD certification that service is necessary
Def: CMS Allowable - Amount/maximum CMS allows for payment
Def: Common Working File (CWF) - There are 9 across the USA; house all patient data and claims
history.
Def: Coordination of Benefits - Determining in what order a claim will be paid
Def: Electronic Data Interchange (EDI) - Standards by which claims are transmitted
Def: Fiscal Intermediary (FI) - Process for Medicare Part A
Def: Grouper - Group codes for DRGs (diagnosis related groups)
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