Insurance & coding

Question 1

Premium

Answer 1

The amount you pay for health insurance each month

Question 2

Deductible

Answer 2

The amount of money you pay before insurance will start to help with your medical bill

Question 3

Co-pay

Answer 3

Set fee you pay for a dr visit or prescription

Question 4

Coinsurance

Answer 4

Percentage of costs AFTER you’ve met your deductible

Question 5

Out of pocket max

Answer 5

The most you have to pay for covered services in a plan year

Question 6

Release of info form

Answer 6

Specifies which information from a patients medical record may be released and to whom

Question 7

Assignment of benefits

Answer 7

Form a patient signs that authorizes health insurance plans to send payment directly to provider

Question 8

Explanation of benefits

Answer 8

Document send from the insurance company to the insured

Question 9

Fee schedule

Answer 9

Defines how much a doctor will be paid for each service they provide

Question 10

Pre authorization

Answer 10

Prior approval for treatment and procedures

Question 11

HMO

Answer 11

In network

Question 12

PPO

Answer 12

Out of network

Question 13

ICD-10-CM

Answer 13

Code diagnoses

Question 14

CPT

Answer 14

Code medical services, procedures, and treatments

Question 15

HCPCS

Answer 15

Code medical equipment and supplies

Question 16

Upcoding

Answer 16

Billing for a service at a higher level than was actually provided