MEDICAL BILLING & CODING: FINAL
EXAM STUDY GUIDE COMPLETE
DETAILED CASE STUDY
wMedicare - The largest federal program providing healthcare is __________________ which provides
health insurance for citizens aged 65 and older as well as certain patients under the age of 65.
Medical Assistant - The ___________________ ______________ is responsible for filing insurance claims
in most medical offices..
Assignment, Benefits - Patients are generally asked to sign an _____________ of
_____________statement, in which the provider agrees to prepare healthcare claims for patients,
receive payments directly from the payers, and accept a payer's allowed charge.
Policyholder - The ______________ may be called the insured, the member, or the subscriber.
Premium, an annual charge - Under an insurance policy, the policyholder pays a __________ or
_________________________ for keeping the insurance policy in force.
Deductible - A ___________________ is a fixed dollar amount that must be paid or "met" once a year, in
addition to the premium, before the third-party payer begins to cover medical expenses.
Co-payment - A ____________________ is a small, fixed fee collected at the time of the visit from the
patients who belong to a managed care health plan.
After - In a typical medical practice, claims are transmitted within a few business days ____________ the
date of service.
Diagnosis code - Insurance claims could be denied as a billing error because if the treatment was not
medically necessary based on the ____________________ and there is no evidence of code linkage.
, Review, Allowable - In the ____________ for ___________ benefits, the claims department compares
the fees the physician has charged with the benefits provided by the patient's health insurance policy to
determine the amount of deductible or coinsurance the patient owes.
liability - The total amount the patient owes the practice, including coinsurance, copayment, deductible,
and noncovered services, is known as the patients __________________.
Liability - _____________________ insurance covers injuries caused by the insured or that occurred on
the insured's property.
Automatic - Although eligibility for Medicare Part B is automatic for people entitled to Medicare Part B
coverage is not ______________________.
hospital - Medicare Part A is a _______________ benefit for patients who are admitted as inpatients for
up to the 90-day benefit period.
60 - A Medicare benefit period begins the day a patient is admitted to the hospital and ends when that
patient has not been hospitalized or placed in a skilled nursing facility for a period of ________
continuous days after discharge.
assistance, insurance - Medicaid is a health cost _________________ program designed for low-income,
blind, or disabled patients. It is not an ______________ program.
Medicare - Workers of any age who have chronic kidney disease requiring dialysis or end-stage renal
disease (ESRD) requiring transplant are eligible for ________________.
Respite - ____________ is a short break provided for caregivers to terminally ill patients. The patient is
moved to a respite care center or other facility to remove responsibility for care from the caregiver
temporarily.
Hospice - ____________ programs provide pallitative care, including pain relief and support for terminal
patients and their family members.
EXAM STUDY GUIDE COMPLETE
DETAILED CASE STUDY
wMedicare - The largest federal program providing healthcare is __________________ which provides
health insurance for citizens aged 65 and older as well as certain patients under the age of 65.
Medical Assistant - The ___________________ ______________ is responsible for filing insurance claims
in most medical offices..
Assignment, Benefits - Patients are generally asked to sign an _____________ of
_____________statement, in which the provider agrees to prepare healthcare claims for patients,
receive payments directly from the payers, and accept a payer's allowed charge.
Policyholder - The ______________ may be called the insured, the member, or the subscriber.
Premium, an annual charge - Under an insurance policy, the policyholder pays a __________ or
_________________________ for keeping the insurance policy in force.
Deductible - A ___________________ is a fixed dollar amount that must be paid or "met" once a year, in
addition to the premium, before the third-party payer begins to cover medical expenses.
Co-payment - A ____________________ is a small, fixed fee collected at the time of the visit from the
patients who belong to a managed care health plan.
After - In a typical medical practice, claims are transmitted within a few business days ____________ the
date of service.
Diagnosis code - Insurance claims could be denied as a billing error because if the treatment was not
medically necessary based on the ____________________ and there is no evidence of code linkage.
, Review, Allowable - In the ____________ for ___________ benefits, the claims department compares
the fees the physician has charged with the benefits provided by the patient's health insurance policy to
determine the amount of deductible or coinsurance the patient owes.
liability - The total amount the patient owes the practice, including coinsurance, copayment, deductible,
and noncovered services, is known as the patients __________________.
Liability - _____________________ insurance covers injuries caused by the insured or that occurred on
the insured's property.
Automatic - Although eligibility for Medicare Part B is automatic for people entitled to Medicare Part B
coverage is not ______________________.
hospital - Medicare Part A is a _______________ benefit for patients who are admitted as inpatients for
up to the 90-day benefit period.
60 - A Medicare benefit period begins the day a patient is admitted to the hospital and ends when that
patient has not been hospitalized or placed in a skilled nursing facility for a period of ________
continuous days after discharge.
assistance, insurance - Medicaid is a health cost _________________ program designed for low-income,
blind, or disabled patients. It is not an ______________ program.
Medicare - Workers of any age who have chronic kidney disease requiring dialysis or end-stage renal
disease (ESRD) requiring transplant are eligible for ________________.
Respite - ____________ is a short break provided for caregivers to terminally ill patients. The patient is
moved to a respite care center or other facility to remove responsibility for care from the caregiver
temporarily.
Hospice - ____________ programs provide pallitative care, including pain relief and support for terminal
patients and their family members.
