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Chapter 15 and 16

Horizontales
Is a cost-sharing measure in which the policyholder pays a fixed dollar amount.
Used to identify an individual
Are performed electronically rather than by humans
The process of patient financial and health information moving into, through, and out of the healthcare facility
Is a quantifiable measure used over time to determine whether some structure, process, or outcome in the provision of a care to a patient supports.
This is something a healthcare organization should have.
Is a medical condition that coexists with the primary cause for hospitalization and affects the patients treatment and length of stay
Is the amount of cost usually annually, the policyholder incur before the plan will assume liability for the remaining covered expenses.
Is a pre-established percentage of eligible expenses after the deductible is met
Is used to identify an insurance company that pays for the medical care of covered individuals
Is a set amount per month or year
Is a verification the patient is currently covered by the plan on the date of services and the services provided are covered by the plan
Verticales
Which represents the services and supplies provided to a patient during his or her encounter
Where the provider charges the patient for the remainder of the costs not paid by the insurance plan
Dictates the physicians cannot receive money or other benefits for referring patients to a healthcare facility.
What is an example of Meaningful use
This was signed into law in 2010 providing health coverage for all Americans
What is it called when they pay of the services provided with their own funds
Is a term used by insurance industry and refers to the process of the paying, denying
Which is the patients medical condition or treatment
Was enacted as title XVIII amendment to the social Security act of 1935