#1
What is medical billing?
The process of submitting and following up on claims with health insurance companies
ExplanationProcess of handling insurance claims for healthcare services.
#2
What is a claim in medical billing?
A request for reimbursement submitted by the healthcare provider to the insurance company
ExplanationRequest for reimbursement from healthcare provider to insurance company.
#3
What does CPT stand for in medical billing?
Current Procedural Terminology
ExplanationStandardized codes for medical procedures.
#4
What is ICD-10 in medical billing?
A coding system used to classify diseases and medical conditions
ExplanationSystem for classifying diseases and medical conditions.
#5
What is the purpose of a clearinghouse in medical billing?
To process insurance claims electronically
ExplanationElectronic processing of insurance claims.
#6
What is the role of a medical coder in the claims processing cycle?
To translate medical procedures into universal codes
ExplanationTranslating medical procedures into universal codes.
#7
What is a deductible in health insurance?
A fixed amount the insured person must pay before the insurance company begins to cover expenses
ExplanationInitial amount payable by insured before coverage.
#8
What is a common reason for claim denials in medical billing?
Incomplete patient information
ExplanationDenial due to incomplete patient details.
#9
What does CMS stand for in the context of medical billing?
Center for Medicare & Medicaid Services
ExplanationFederal agency overseeing Medicare and Medicaid.
#10
What is revenue cycle management in medical billing?
The process of managing the flow of money within a healthcare organization
ExplanationManaging financial flow within healthcare organizations.
#11
What is the purpose of HIPAA in medical billing?
To protect patients' privacy and security of health information
ExplanationEnsuring privacy and security of health data.
#12
What is a UB-04 form used for in medical billing?
To bill for outpatient hospital services
ExplanationBilling form for outpatient hospital services.