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Kinn's Medical Assistant 14th Edition- CH 15 All Possible Questions and Answers with complete solution $7.99   Add to cart

Exam (elaborations)

Kinn's Medical Assistant 14th Edition- CH 15 All Possible Questions and Answers with complete solution

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  • Kinn\'s Medical Assistant 14th Edition- CH 15

provider web portal - a secure online website that gives contracted providers a single point of access to insurance companies this allows the provider to determine eligibility and deductible status, submit preauthorizations/precertifications, and check the status of claims. Explanation of Benefi...

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  • August 25, 2024
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  • 2024/2025
  • Exam (elaborations)
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  • Kinn's Medical Assistant 14th Edition- CH 15
  • Kinn's Medical Assistant 14th Edition- CH 15
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PatrickKaylian
Kinn's Medical Assistant 14th Edition-
CH 15
provider web portal - a secure online website that gives contracted providers a single point of
access to insurance companies this allows the provider to determine eligibility and deductible status,
submit preauthorizations/precertifications, and check the status of claims.




Explanation of Benefits (EOB) - A document sent by the insurance company to the provider and
the patient explaining the allowed charge amount, the amount reimbursed for services, and the patient's
financial responsibilities.



adjudicate - to settle or determine judicially



audit - a process completed before claims submission in which claims are examined for accuracy
and completeness



capitation - a payment arrangement for healthcare providers. The provider is payed a set amount
for each enrolled person assigned to them, per period of time, whether or not that person has received
services



claims clearinghouse - an organization that accepts the claim data from the provider, reformats
the data to meet the specifications outlined by the insurance plan, and submits the claim



claim scrubbers - software that finds common billing errors before the claim is sent to the
insurance company



CMS-1500 Health Insurance claim form - the standard insurance claim form used for all
government and most commercial insurance companies.



copayment (copay) - A set dollar amount that a patient must pay out-of-pocket for medication
when it's dispensed

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