Question

The ss Healthcare s. is the maximsm that third-party payers will pay for a procedure or service through a process called credentialing providers need to apply to become a The nesource based relative value scale includes the following three parts aof healthcare organization that constracts with various healthcare usually takes 3 to 10 working days for review and approval. This type of 40 providers and medical facilities at a reduced payment schedule for their insurance memhers 41. Ain) aelerral is used when the physician believes that the paticnt mest see a specialist to continus 42 Prescription drugs are covered by Medicare SKOLLS AND CONCEPTS Match the following terms and definitions Medicaida A federally sponsored health insurance program for those over 65 years or disabled individuals under 65 years _Modicare erm sonsetimes applied to private insurance products that supplement Medicare insurance benefits c. A federally and state-sponsored health insurance program for the medically indigent Read the following paragraph and then fill in the blanks The medical assistant's tasks related to health insurance processing are initiated when the patient encounters the provider by appointment, as a walk-in, or in the emergency department or hospital. To complete insurance billing and coding properly. the medical assistant must perform the following tasks: 1 Obain information from the patient andlor the guarantor, inchading and data. for insurance payment with the insurance carrier or carriers, as is required 2 Verify the patient's well as insurance exclusions, and whether to refer patients to specialists or to perform certain services or procedures, such as surgery or diagnostic tests 3. Obeain for referral of the patient to a specialist or for pecial services or procedures that require advance permission.

Answer 1

37.Allowed amount.

38.Participating Provider
39.
a. Provider Work
b. Charge-based professional liability expense
c. Charge-based overhead

40.
Managed Care Plan
41.

Regular referrals

42.
Part D

skills and concepts...
C - Medicaid
A - Medicare
B - Medigap

Fill in the blanks...

1.Demographic and insurance or emoloyment data

2.Eligibility,as well as insurance deductibles,whether statement is required.

3.pre autorization