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Medisoft Terms 1-7
Stack #189795
Question | Answer |
---|---|
policyholder | a person who buys an insurance plan |
heath plan | a plan or organzation that provides health benefits |
premium | the periodic amount of money the insured pay to a heath plan for insurance coverage |
fee for service | health plan that repays the policyholder for covered medical expenses |
managed care | type of insurance that is responsible for both the financing and the delivery of health care |
capitation | advance payment to a provider that covers each plan member's health care services for a certain periold of time |
preferred provider organization | managed care of health care providers who agree to perform services for plan members at discounted fees. |
back up data3 a copy of data files made at a specific point in time that can be used to restore data to the system | |
guarantor | an individual who may or may not be a pt of the pratice but who is the insurance policyholder |
capitated plan | insurance plan in which payments are made to primary care providers whether patients visit the office or not |
health maintenance organization | type of managed care system in which providers are paid fixed rates at regular intervals |
explanation of benefits | a paper document from a health plan that lists the amount of a benefit and explains how it was determined |
clearinghouse | an organization that receives claims from a provider checks and prepares them for precessing and transmits them to insurance carriers in a standardized format |
information technology | computer hardware and software systems |
purging data | the process of deleting files of patients who are no longer seen by a provider in a pratice |
record of treatment and progress | physicians notes about a patients condition and diagnosis |
adjustments | changes to patients accounts |
multilinks | groups of procedure code entries that are related to a single activity |
filter | a condition that data must meet to be selected |
remittance advice | an electronic document from a health plan that lists the amount of a benefit and explanins how it was determined |
copayment | a small fixed fee paid by the patient at the time of an office visit |
practice management program | a software program that automates many of the administrative and financial tasks required to run a medical pratice |