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Lifecycle of a Medical Claim
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Lifecycle of a Medical Claim
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25 Questions

1. An independent - not-for-profit organization - the joint commission accredits and certifies more than 15 - 000 healthcare organizations and programs in the united states. Joint commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization's commitment to meeting certain performance standards

2. Clearinghouse

3. Chartered in 1979 by ansi to create uniform standards for all electronic data interchange documents

4. Claims log or claims register

5. Concurrent review:

6. Reconciliation

7. Discharged not final billed (dnfb)

8. The electronic version of the ub-04 is the

9. Eob statement has three sections

10. Ub-04

11. Stands for the accredited standards committee x12

12. National coverage determinations (ncds)

13. Department of justice (doj)

14. Benefit payment information.

15. Aging report

16. Npi

17. Billing two or three procedures when the services are typically covered by a single comprehensive code

18. Documents may be sent via telecommunications or physically transported on electronic storage media.

19. Administrative simplification compliance act

20. Carrier

21. Electronic version of the cms 1500 paper claim is the

22. Four major steps in the rcm

23. Types of bills (tobs)

24. Regulatory compliance

25. Peer review

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