QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
EOB ~ Explanation of Benefits - ANSWER Form sent to physician or patient detailing benefits paid or
denied by the ins. co.
Decipher means? - ANSWER Interpreting of meaning of.
EFT ~ Electronic Funds Transfer means? - ANSWER Payment method where funds are deposited early
into physicians bank account.
Insurance adjustment means? - ANSWER Dollar amt adjusted off the patient's acct reflecting the diff.
btween the fee for services billed & allowed amt determined by ins. co.
Posting means? - ANSWER Making an entry in the patient's acct.
Rejected claim means? - ANSWER Refused to accept.
Denied claim means? - ANSWER Refused to grant ~ payment for claim.
Non-covered means? - ANSWER Service or procedure not listed as covered benefit in the payer's master
benefit list.
Unauthorized means? - ANSWER Authorization or approval not obtained prior to treatment.
what is an Appeal? - ANSWER Procedure used when payer denies a service Patient thinks is needed or
refuses to pay for care that the patient already received.
Aging Reports mean? - ANSWER grow old.
, What is a Follow-up? - ANSWER Checking the status of a claim.
Rebill means? - ANSWER Resubmit a claim.
Insurance Aging Report means? - ANSWER Report showing monies owed to the physician from ins. co.
Patient Aging Report is ? - ANSWER Report showing monies owed to the physician from patients ~
balances due.
Outstanding means? - ANSWER Not yet paid.
Maintaining means? - ANSWER Keeping current.
Cash flow is? - ANSWER Stream of cash (income) used for disbursements.
Overhead is? - ANSWER Business expense.
Post-dated check - ANSWER Check dated for the future.
Soft collections are? - ANSWER Mailing/calling patient-due statements reminding of their past-due
balances.
what is a Write off - ANSWER Dollar amt adjustment due from patient/ins. co. to reflect zero balance due
on claim in question or sometimes patient's entire bal.
Collection Agency is ? - ANSWER Agency retained by the practice for purpose of collecting debts.
Department of Insurance - ANSWER Government agency in charge of controlling & regulating ins. co.
State Insurance Commissioner - ANSWER Appointed official in charge of each state's Dept. of Ins.