The Parent Company That Develops a Product or Business Process

question 70

Multiple Choice

The parent company that develops a product or business process and sells the rights is known as the

• A) Franchisor
• B) Franchisee
• C) Company of origin
• D) Opening company

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Definitions:

Explanation of Benefits (EOB)

A printed description of the benefits provided by the insurer to the beneficiary; provides information to the patient about how an insurance claim from a health provider (such as a physician or hospital) was paid on his or her behalf.

Not Allowed Amount

The portion of a bill or charge that is not covered by insurance and is not the responsibility of the patient or client.

Coinsurance Co-payment Amount

The fixed percentage or amount that an insured person is responsible for paying for medical services, after the deductible is met.

CMS-1500 Form

The standard claim form designed by the Centers for Medicare and Medicaid Services to submit physician services for third-party (insurance companies) payment; the standard paper claim form to bill Medicare Fee-For-Service (FFS) Contractors when a paper claim is allowed.