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Terms in this set (44)The Health Information for Economic and Clinical Health HITECH Act is Intended to promote the use of EHR's in physician's practices and hospitals through the use of financial incentives To be eligible for financial incentives Providers must do more than simply purchase EHRs they must demonstrate meaningful use of electronic health records An accountable care organization is A network of doctors and hospitals that share responsibility for managing the quality and cost of care provided to a group of patients A PMP is A software program that automates the administrative and financial tasks require to run a medical practice A major component of order management is electronic prescribing the use of computers and handheld devices to transmit prescriptions to pharmacies in digital format Coding is the process of translating a description of diagnosis or procedure into a standardized code In oder for the physician to receive payment each patient visit must be carefully documented and must contain two very important pieces of information the diagnosis and the procedure The ICD-9-CM was used for diagnostic codes in the medical office until october 2015 when ICD-10-CM codes went into effect The current procedural terminology CPT is used for procedure codes in the medical office The patient's primary complaint Is assigned a diagnosis code from the international classification of diseases ICD Each procedure the physician performs is assigned a procedure code that stands for the particular service, treatment, or test. This code is selected from the Current Procedural Terminology CPT A clearinghouse is A company that receives electronic claims from medical practices and forwards the claim to the appropriate health plan Adjudication is A series of steps designed to determine whether a claim should be paid The remittance advice lists the transactions included On the claims and the amount paid and if appropriate, providers an explanation of why certain charges were not paid in full or were denied entirely Revenue cycle management refers to the activities associated with a patient encounter to ensure that the provider receives full payment for services HIPAA was legislation designed to ensure the security and privacy of health information among other things Most physician practices are require to use the HIPAA-standard electronic claim format called X12-837 Health Care Claim or 837P for short. this claim is called The Professional claim because it is used to bill for a physician's services As part of the Administrative Simplification efforts, unique identifiers were proposed for the purpose of standardizing the identification numbers for providers employees health plans and individuals to ensure future consistency and was of use Under the law each healthcare provider was assigned a unique National Provider Identifier NPI which is a ten-position identifier consisting of all numbers Health information is information about a patient's past, present, or future physical to mental health; or payment for healthcare. If health information can be used to find out s person's identification, it is referred to as protected health information PHI An audit is A formal examination or review undertaken to determine whether a healthcare organization's staff members comply with regulations Many providers now offer patients access to a patient portal Secure online website that providers patients with the ability to communicate with their provider and access their information at any time. Providers also use secure electronic messaging to send patients reminders for preventive and follow-up care Fifteen minutes is the default length of time for An appointment in office hours The repeat box is used to Enter appointments that recur on a regular basis Office Hours makes it easy to locate an appointments slot that meets specified requirements with the Search for Open Time Slot shortcut button It is useful have account balance information Available at the front desk when check in. The quickest way to open a patient case is To double-click on the line associated with a patient case Charges are the amounts a provider bills for the services performed Examples of adjustments include returned checks, discount for cash patients, and refunding of overpayments I Medisoft, transactions are entered in The Transaction Entry dialog box One way to locate a chart number is To key the first several letters of a patients last name The Deposit List feature is Very efficient for entering large insurance payments that must be split up and applied to a number of different patients The color red is applied to Payments, Adjustments, and comments section to indicate an unapplied payments A deductible is An amount that is due before benefits begin and must be paid Clean claims communicate The correct information about a patients diagnosis and procedures and the charges to payer` Once the services a patient has received from a provider have been entered into the PMP, the next step is to Create insurance claims A fee schedule is A Document that specifies the amount a provider bills for provided services A payment schedule is A Document that specifies the amount the peter agrees to pay the provider for a service, based on a contracted rate of reimbursement In order to adjust the patient accounts of those covered by The capitated plan a second deposit is entered with a zero amount Locating patients who have claims during a month covered by a capitation payment is Accomplished using the List Only ... button in the Claim Management dialog box The procedure for adjusting patient accounts must be followed for Each patient who has transactions during the time period covered by the capitation payment Reminder statements list only Those charges that are not paid in full after all insurance carrier payments have been received An aging report lists the amount of money owed to the practice organized by the amount of time the money has been owed An insurance aging report shows How long a payer has taken to respond to each claim In most aging reports a patients account is considered Current up to 30 days Students also viewedEHR Study Guide Chapter 167 terms chapter 1 cimo mom lab quiz 469 terms Chapter 1 CIMO51 terms Medical Billing & Coding200 terms Sets found in the same folderComputers of the Medical Office Vocabulary123 terms Computers in the Medical Office87 terms Medical Billing21 terms MED 131 final48 terms Other sets by this creatorPhlebotomy Tube Colors and Additives23 terms Anatomy of the back and spine44 terms Types of Body Movements20 terms Musculoskeletal Anatomy102 terms Recommended textbook solutions
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Which of the following is the process of sorting or grouping patients according to the seriousness of their condition?Triage involves sorting large numbers of patients into categories according to the urgency of their needs [4].
Which specialized type of progress note provides healthcare professionals?WGU BDV1 Mod 4 Health Data Management across the continuum (AHIMA C2V3). What information should you see on all forms in a patient chart?Medical charts contain documentation regarding a patient's active and past medical history, including immunizations, medical conditions, acute and chronic diseases, testing results, treatments, and more.
Who enters the data into a personal health record?Information in an electronic health record or “EHR” is typically entered by and accessed by health care providers. It may only have information from one health care provider or a group practice.
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Each procedure (service, treatment, or test) the physician performs is assigned a
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