Upgrade to remove ads
Only ₩37,125/year
- Science
- Medicine
- Health Computing
-
Flashcards
-
Learn
-
Test
-
Match
-
Flashcards
-
Learn
-
Test
-
Match
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
practice management programs
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
International classification of disease
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
(the illness or condition that is the reason for the visit)
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 1
67 terms
chapter 1 cimo mom lab quiz 4
69 terms
Chapter 1 CIMO
51 terms
Medical Billing & Coding
200 terms
Sets found in the same folderComputers of the Medical Office Vocabulary
123 terms
Computers in the Medical Office
87 terms
Medical Billing
21 terms
MED 131 final
48 terms
Other sets by this creatorPhlebotomy Tube Colors and Additives
23 terms
Anatomy of the back and spine
44 terms
Types of Body Movements
20 terms
Musculoskeletal Anatomy
102 terms
Recommended textbook solutions
Clinical Reasoning Cases in Nursing
7th EditionJulie S Snyder, Mariann M Harding
2,512 solutions
Pharmacology and the Nursing Process
7th EditionJulie S Snyder, Linda Lilley, Shelly Collins
388 solutions
Medical Terminology: Learning Through Practice
1st EditionPaula Manuel Bostwick
1,562 solutions
Introduction to Sports Medicine and Athletic Training
2nd EditionRobert C. France
400 solutions
Other Quizlet setssport management #1
30 terms
Biol 1002 Final
57 terms
acct chapter 12
23 terms
Exam I: Bones and the Skeletal System
29 terms
Flickr Creative Commons Images
Some images used in this set are licensed under the Creative Commons through
Flickr.com.
Click to see the original works with their full license.
- 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 patient's primary complaint (the illness or condition that is the reason for the visit)
- Each procedure the physician performs is
- A clearinghouse is
- The remittance advice lists the transactions included
- Revenue cycle management refers to
- 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
- Health information is information about a patient's past, present, or future physical to mental health; or payment for healthcare.
- Charges are
- I Medisoft, transactions are entered in
- A deductible is
- The procedure for adjusting patient accounts must be followed for
- In most aging reports a patients account is considered