I N S U R E D E E 6 D 7 A S S I G N M E N T U 8 C F F M C C I 11 P O R T A B I L I T Y B L T A L I A O Y L 14 I N D E M N I T Y
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1 1 V 2 C O 3 B R A 4 D 5 I N S U R E D E E R N 6 D 7 A S S I G N M E N U 8 C F F 9 C 10 C O O R D I N A I O N M C C I 11 P O R A B I L I Y B L A L I 12 C O I N S U R A N 13 C E A O Y L 14 I N D E M N I Y 15 A P C 17 M P I M 18 R E F E R R A L M S 16 C 2. Federal law requiring employers to permit 1. he process of accurately accounting for all employees to continue their group health AD activity within or across entities insurance coverage after termination (Census ) 5. Person who is the holder of an insurance 3. Person designated to receive proceeds of an policy insurance policy 6. Osteopathic physician 4. Fixed sum of money that beneficiary must contribute towards the cost of their healthcare before insurance benefits begin 7. Written authorization form policyholder for their insurance company to pay benefits directly to the care provider 9. Portion of bill that beneficiary must contribute once insurance benefits have begun ( pay) 10. Insurance claims review process used when a beneficiary is insured by two or more carriers 8. Conducting ourselves ethically and within the law of business practices 13. Bill submitted to insurance company for payment
2 Getting Started (Cont d) 11. Health Insurance and Accountability Act 12. Cost sharing in which the subscriber is responsible for a specific percentage of the cost of healthcare 14. ype of large group insurance plan where employees have access to care anywhere in the country without a referral 15. System similar to DRGs used for outpatient services 17. Master Index of Patients 18. Form used in managed care plans for the PCP s authorization for certain specialist and certain services 16. he Administrative branch within the Department of Health and Human Services that is responsible for Medicare and Medicaid Services
3 1 M S 2 P 3 L A B O R 4 E I 5 J C A H O 6 P R E A D 7 M I I 8 A S B E 9 H R 10 P P O 11 I C D 9 12 O R D E C N L I S E A I C 14 U P I N F L A 15 P I F Y R R E 16 A 17 D 18 E D I C A I D R M 19 C L A I M S M L A U E P A 20 O L M 21 P R E M I U 22 M 23 E O B Y G D 13 R 1. Questionnaire to determine primary payor before Medicare 2. Health Information (PHI - protected by HIPAA) 3. EMA_A 3. Legal responsibility or accountability 5. An organization that administers health insurance plans or claims but does not assume 4. An Insured individual is legally obligated to pay for services rendered by a provider the risk (PA) 6. Create a registration record for a future 7. Federal health insurance plan primarily for inpatient service 10. Insurance plans that provide its members with incentives to use designated healthcare providers seniors 8. System similar to DRGs used for outpatient services 11. Diagnosis coding system 9. Setting for inpatient care
4 Getting Deeper (Cont d) 12. physician s written or verbal instruction 13. Form used in managed care plans for the directing a patient s diagnostic and therapeutic PCP s authorization for certain specialist and treatment certain services 14. Unique Physician Identifier 15. Principal ( Physician); 1 st (Payor) 18. Joint federal and state program to provide 16. Having a short and relatively severe course Medical insurance for the poor 19. medical bills 17. Per (day) 21. Payment for insurance coverage 18. Questionnaire used to identify the primary payor over Medicare 23. Document educating patient about 20. Enforcement arm of CMS whose mandate insurance payments or denials is to fight waste, fraud, and abuse 22. Medical Doctor
5 1 C 2 O N F 3 I 4 D E N I A 5 L 6 A U 7 D R A L 8 R E G I S R A I O N P N E S 9 D A Y 10 W 11 C 13 I N F O R M A I O N 14 V I A F Y D P E I F A N 15 S C H E D U L I N G A N I 16 P A I E N D E A I I N O 17 C O N S U L 18 C E N S U S G 12 I Across Down 1. Not to be disclosed 2. Ambulatory Patient 7. Physician 3. Document verifying patient name 8. Collection and storage on patient 4. Diagnosis Related Group demographic, insurance, and clinical data 9. Same Surgery 5. Overdue 13. Providing patient room number to callers and visitors (Patient ) 6. Average Length of Stay 14. Route, by way of 10. Directions, maps, information on how to get to correct location 15. Making appointment 11. Corporate Identifier 16. Healthcare Consumer 12. Admitted for multi-day stay 17. Ask the advice of a colleague or other 16. Physician Assistant care provider 18. Official count/list of patient population
6 1 P O 2 R 3 A B I L I Y A N C 4 C W 5 F 6 S C 7 L O I 8 D E E R M I N A I O N C E B R O D O D 9 B E N I F I C I A R Y 10 I C D D N 11 P A S A 12 M E D I C A R E 13 I R N Y 14 D I S E A S E I D O 15 O E X 18 P L 19 A N A I 20 O N 21 N P X P D I A 22 D O 23 D R G 1. HIPAA (Health Insurance and 1. Physician Assistant Accountability Act 4. National File of Medicare Claim 2. Registered Nurse Common Working File 8. PSDA (Patient Self Act) 3. JCAHO (Joint Commission on of Healthcare Organizations 9. ABN (Advance Notice) 10. International Classification of Disease 4. COB ( of Benefits) (9 th Revision commonly in use) 11. Patient Access Services 5. Organization contracted with CMS to process and pay Medicare claims - Fiscal Intermediary 12. CMS (Centers for and Medicaid 6. MSP (Medicare Payor) Services) 14. CDC Centers for Control and 7. EMALA (Emergency Medical Prevention reatment and Act) 15. Overtime 13. MPI (Master Patient ) 17. EOB ( of Benefits) rd Party Administrator 21. Nurse Practioner 18. Preferred Provider Organization 22. Osteopathic Physician 19. Admission, Discharge, ransfer 23. Diagnosis Related Group 20. Office of Inspector General
7 1 H 2 A R 3 D 4 W A R E 5 B 6 I L O A 7 A S 8 P N P L A 9 E C H N O L O G Y C S E A H S R 10 I N E R 11 F A C 12 E W N U I N O 13 W E B 14 M P I L R R E 15 K E Y B O A R D 16 M R L O I 17 D 18 N U L L 19 F U N C I O N E 20 C S S 21 F I E L D S E K R 1. Computer Equipment, machinery 2. Letters, Numbers, Punctuation, Symbols - data accepted in computer fields or coding 7. Application Service Provider 3. act, perform 9. Skills, tools, equipment; the practical 4. Paper background image on monitor use of scientific knowledge in industry and everyday life 10. set of statements, functions, options 5. Group of similar input data processed during single that link users to computer programs or machine run allow data to flow between programs 13. Net - World Wide ( )- 6. World Wide Web 14. Master Person Index 8. Secret combination of alphanumeric characters used to protect computer access 15. Input device used in typing 11. organized collection of data that is stored in the memory of a computer, and can be accessed and manipulated as a single named unit 18. void, empty field 12. member of database 19. ask, Utility, Job; special purpose or 16. Input devise used to control pointer on computer task of a computer key 21. Spaces for data entry; an area of knowledge, interest or study screen 17. Portable, off-line data storage devise 20. Electronic Clinical Record; Clinical Data Repository
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