EXAM STUDY GUIDE
1. abstracting: the extraction of specific data from a medical record, often for
g g g g g g g g g g g g
use in an external database, such as a cancer registry
g g g g g g g g g
2. abuse: practices that directly or indirectly result in unnecessary costs to the Medi
g g g g g g g g g g g g
care program
g
3. account number: number that identifies specific episode of care, date of service, or patien
g g g g g g g g g g g g g
1g/g7
,4. accounts receivable department: Department that keeps track of what third-
g g g g g g g g g
party payers the provider is waiting to hear from and what patients are due to make a
g g g g g g g g g g g g g g g g
payment.
g
5. activity/status date: Indicates the most recent activity of an item.
g g g g g g g g g
6. actual charge: the amount the provider charges for the health care service
g g g g g g g g g g g
7. Administration Simplification Compliance Act (ASCA): specifically prohibits a
g g g g g g g
ny payment by Medicare for services or medically necessary supplies that are not sub
g g g g g g g g g g g g g
mitted electronically
g
8. administrative services only (ASO) contract: Contract between employers and pri
g g g g g g g g g
vate insurers under which employers fund the plans themselves, and the private insure
g g g g g g g g g g g g
rs administer the plans for the employers.
g g g g g g
2g/g7
, 9. Advance Beneficiary Notice of Noncoverage (ABN): Form provided if a provi
g g g g g g g g g g
der believes that a service may be declined because Medicare might consider it unnec
g g g g g g g g g g g g g
essary.
10. aging report: Measures the outstanding balances in each account.
g g g g g g g g
11. allowable charge: The amount an insurer will accept as full payment, mi
g g g g g g g g g g g
nus applicable cost sharing.
g g g
12. APC grouper: Helps coders determine the appropriate ambulatory pay
g g g g g g g g
ment classification (APC) for an outpatient encounter.
g g g g g g
13. assignment of benefits: Contract in which the provider directly bills the payer
g g g g g g g g g g g g
and accepts the allowable charge.
g g g g
3g/g7