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Advance Beneficiary Notice (ABN) -ANSWER A form provided to the patient when the
provider believes Medicare will probably not pay for services received
Allowed Amount -ANSWER The maximum amount a third-party payer will pay for a
particular procedure or service
Copayment -ANSWER a small fixed fee paid by the patient at the time of an office visit
Coinsurance -ANSWER a provision under which both the insured and the insurer share
the covered losses, typically 80:20
deductible -ANSWER specific amount of money a patient must pay out of pocket before
the insurance carrier begins paying
Explanation of Benefits -ANSWER a form created by the insurance company to explain
what charges were covered, denied, or need more documentation based on the claims
submitted by the physician's office
Participating provider (PAR) -ANSWER Providers who agree to write off the difference
between the amount charged by the provider and the approved fee established by the
insurer
Medicare -ANSWER A federal program of health insurance for persons 65 years of age
and older by Part A (hospitalization) or Part B (routine medical office visits)
Tricare -ANSWER U.S. government health insurance plan for all military personnel
CHAMPVA -ANSWER covers surviving spouses and dependent children of veterans who
died as a result of service-related disabilities
Medicaid -ANSWER provides health insurance to the medically indigent population
through a cost-sharing program between federal and state governments for those who
meet specific eligibility criteria
Managed Care -ANSWER is an umbrella term for plans that provide health care in return
for preset scheduled payments and coordinated care through a defined network of
providers and hospitals
,CMS-1500 form -ANSWER Standard insurance form used by all government and most
commercial insurance payers.
- 33 blocks
- divided into three section
CMS-1500 Section 1 -ANSWER Carrier Block: contains the address of the insurance
carrier and is located at the top of the form
CMS-1500 Section 2 -ANSWER Patient/insured section: contains information about the
patient or insured; includes boxes 1-13
CMS-1500 Section 3 -ANSWER Physician/Supplier Section: contains information about
the physician or supplier: boxes 14-33
Supine Position -ANSWER
Dorsal Recumbent Position -ANSWER
Sims' Position -ANSWER
Knee-elbow position -ANSWER
Fowler's Position -ANSWER
Lithotomy Position -ANSWER
Epidural Injection -ANSWER epidural space of the spine
Intra-arterial Injection -ANSWER injection into an artery (to break up clots)
Intra-articular Injection -ANSWER injection into joint space
Intradermal Injection -ANSWER Skin of the upper chest, forearms, upper pack. 5-15º
angle
intramuscular injection -ANSWER deltoid, vastus lateralis, ventrogluteal muscles
Intraosseous Injection -ANSWER Bone marrow
Intraperitoneal Injection -ANSWER within the peritoneal cavity
Intrapleural Injection -ANSWER pleural space (lungs)
Intrathecal Injection -ANSWER Subarachnoid space (brain)
Fat soluble vitamins -ANSWER A, D, E, K
, Water Soluble vitamins -ANSWER B1, B2, B3, B6, Folate, B12, Pantothenic acid, biotin,
C.
Erikson's stages of psychosocial development -ANSWER 1. trust vs. mistrust
2. autonomy vs. shame and doubt
3. initiative vs. guilt
4. industry vs. inferiority
5. identity vs. role confusion
6. intimacy vs. isolation
7. generativity vs. stagnation
8. integrity vs. despair
Grief Cycle -ANSWER denial, anger, bargaining, depression, acceptance
Sagittal Plane -ANSWER divides body into left and right
Coronal Plane -ANSWER divides body into front and back
Transverse Plane -ANSWER horizontal division of the body into upper and lower portions
Right Upper Quadrant (RUQ) -ANSWER Right lobe of liver, gallbladder, right kidney,
portions of stomach, small and large intestine
Left Upper Quadrant (LUQ) -ANSWER Left lobe of liver, stomach, pancreas, left kidney,
spleen, portions of large intestine
Right Lower Quadrant (RLQ) -ANSWER cecum, appendix, right ovary and tube, right
ureter, right spermatic cord
Left Lower Quadrant (LLQ) -ANSWER contains parts of the small and large intestines, left
ovary, left fallopian tube, left ureter
Epigastric Region -ANSWER located above the stomach
Umbilical Region -ANSWER
hypogastric region -ANSWER
Right Hypochondriac Region -ANSWER right lateral region just below the ribs
Left Hypochondriac Region -ANSWER left upper region below the rib cartilage
Right lumbar Region -ANSWER right middle region near the waist
Left Lumbar Region -ANSWER