CPB Certified Professional Biller Certification

buse - 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. Allowed Charge - Answer-The Maximum amount the payer will reimburse for each procedure or service, according to the patients policy. All Patient Diagnosis-Related Group (AP-DRG) - Answer-DRG system adapted for use by thirdparty payers to reimburse hospitals for inpatient care provided to non-Medicare beneficiaries