AAPC CPB - Chapter 10 Terminology fully solved 2024/2025

AAPC CPB - Chapter 10 Terminology Bad Debt - correct answer Accounts receivable or money owed that will likely remain uncollectable and will be written off Bankruptcy - correct answer Legal proceeding involving a person who is unable to repay outstanding debts Coordination of Benefits - correct answer Used to ensure that insurance claims are not being paid multiple times Coverage Terminated - correct answer This denial occurs when the patient does not have coverage with the insurance carrier Fair Debt Collection Practices Act (FDCPA) - correct answer States that third-party debt collectors are prohibited from employing deceptive or abusive conduct in the collection of consumer debts incurred for personal, family, or household purposes. Fair Credit Reporting Act - correct answer Protects information collected by the consumer reporting agencies such as the credit bureaus, medical information companies, and tenant screening services. Fee-For-Service (FFS) - correct answer A payment model where payment is made to a provider for each individual service rendered to a patient. Itemized Statement - correct answer A detailed statement (bill) sent to the patient or responsible party reflecting the patient responsibility. Ledger Card - correct answer An account of service descriptions, charges, payments, adjustments, and where current balances are posted. Non-covered Service - correct answer A claim can be denied by the insurance carrier if the service is not covered under the insurance plan Prior Authorization - correct answer Sometimes required by insurance plans for many procedures Prompt Payment Act - correct answer A federal law that ensures that federal agencies pay their bills within 30 days of receipt and acceptance of materials and/or services Relative Value Unit (RVU) - correct answer A standardized way to determine the value of a service. It considers the work done by the physicians, practice expense, and the cost of malpractice Resource Based Relative Value Scale (RBRVS) - correct answer A payment system that considers the work done by the physicians, malpractice insurance, and practice expenses. Practice expenses include overhead, supplies, equipment, and staff salaries Timely Filing - correct answer The claim must be filed within a certain time designated by the third-party payer in order to be processed