Patient Access Jeopardy!!!

Answers and Questions

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Level Admitting & Registration

Insurance Compliance MedicalTerminology

Acronyms Potpourri

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3 ? ? ? ? ? ?4 ? ? ? ? ? ?5 ? ? ? ? ? ?

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Guarantor

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Who is the person that is ultimately responsible for paying the patient’s bill?

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$1068

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What is the Medicare Part A deductible?

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$135

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What is the Medicare Part B deductible?

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All Medicare beneficiaries admitted as in patients.

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Who receives the Important Message from Medicare?

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Consent given in writing or verbally by patient or guardian.

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What is Actual or Explicitly Expressed Consent?

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A fixed sum that a beneficiary must contribute towards the cost of their health

care before insurance benefits begin.

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What is a Deductible?

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The individual who carries the insurance coverage.

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Who is the subscriber?

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A fixed amount the beneficiary pays for health care services, regardless of the actual

charge; the amount is designated as the patient’s responsibility.

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What is a co-pay?

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Approval from third party payors to provide specified care in a particular

setting; written or electronic assurance that the services provided will be

covered under the terms of the patient’s health care plan.

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What is Payor Authorization?

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Validating with third party payors that a given plan is active and

ascertaining the patient’s deductible, co-pay and limitations.

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What is Verification of Benefits?

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To inform the patient that Medicare may not consider the health services being

provided as medically necessary and that there is a good possibility that Medicare will not pay for the service provided and the patient may be billed for the service.

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What is the purpose of the Advance Beneficiary Notice?

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Fraud and abuse, billing practices, Antitrust, quality of care, managed care, bribes and improper payments, conflicts of interest,

environmental concerns, and copyright and software licensing.

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What are compliance issues?

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Corporate Integrity

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What is the act of complying with a request, demand or regulation?

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Fraud committed or attempted using identifying information of another person

without authority.

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What is identity theft?

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The obligation of an employee to let management know of suspected

violations in organizational policies, or federal or state laws.

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What is the duty to report wrong doing?

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A non-invasive test that is used to reflect underlying heart conditions

by measuring the electrical activity of the heart.

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Electrocardiogram

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An x-ray of the breast in a device that compresses and flattens it.

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What is a mammogram?

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A blood draw.

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What is venipuncture?

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Partial or complete loss of consciousness.

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What is syncope?

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High, excessive, beyond normal.

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What is hyper?

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ABN

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What is the Advance Beneficiary Notice?

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IMM

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What is the Important Message from Medicare?

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JCAHCO

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What is the Joint Commission on Accreditation of

Health Care Organizations?

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The physician who supervises a patient’s care during an inpatient stay.

Who is the Attending Physician?

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EMTALA

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What is the Emergency Medical Treatment and

Active Labor Act?

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HIPAA

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What is the Health Insurance Portability and

Accountability Act?

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Written authorization from policy holder for their insurance

company to pay benefits directly to the care provider.

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What is Assignment?

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A physician who specializes in the diagnosis and treatment of cancer.

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Who is an Oncologist?

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Treatment received by a patient in a hospital or clinic. The patient does not

require hospitalization.

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What is Out Patient Care?

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The dollar amount that an insured is legally obligated to pay for services

by a provider.

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What is Patient Liability?

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Thank You for Playing!

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