CPB Certified Professional Biller Certification

Abuse - Answer- Actions inconsistent with accepted, sound medical business or fiscal practice Accept Assignment - Answer- Provider accepts as payment in full whatever is paid on the cliam by the payer (except for any copayment and or coinsurance amounts.) Accounts Receivable - Answer- The amount owed to a business for services or goods provided. Accounts Receivable Aging Report - Answer- Shows the status (by date) of outstanding claims from each payer, as well as payments due from patients. Accounts Receivable Management - Answer- Assists Providers in the collection of appropriate reimbursement for services rendered; include functions such as insurance verification/eligibility and preauthorization of services. Accreditation - Answer- Voluntary Process that a healthcare facility or organization (e.g. hospital or manged care plan) undergoes to demonstarte that it has met standards beyond those required by law. Adjudication - Answer- Judicial dispuite resolution process in which an appeals board makes a final determination. Adjusted Claim - Answer- payment correction resulting in additional payment(s) to the provider. Advance Beneficiary Notice (ABN) - Answer- Document that acknowledges patient responsiblity for payment if Medicare denies the cliam. Adverse Effect - Answer- Also called adverse reaction; the appearance of a pathologic condition due to ingestion r exposure to a chemical substance properly administered or taken. Adverse Reaction - Answer- Also called adverse effect; the appearance of a pathologic condition due to ingestion r exposure to a chemical substance properly administered or taken. Adverse Selection - Answer- Covering members who are sicker then the general population. Allowable Charge - Answer- see limiting charge; maximum fee a physician may charge.