| Question |
Answer |
| QUITS A FIXED SCREEN WITHOUT FILING OR SAVING |
F7Q |
| INSERTS DATE/TIME STAMP ON COMMENTS SCREEN |
F7D |
| JUMP TO PAGE PROMPT |
F7P |
| INSERT MODE/INSERT A COMMENT |
F8 |
| ACTIVATES ACTION CODES |
F9 |
| SAVES INFO IN THE SYSTEM |
F10 |
| REFRESHES SCREEN |
F11 |
| NUM LOCK |
ERASES AN ENTIRE FIELD |
| / |
RESTORES AN ERASED FIELD |
| - |
DELETES CHARACTERS TO THE RIGHT OF THE CURSOR |
| PAGE UP |
MOVES TO PREVIOUS PAGE OF A FORM |
| PAGE DOWN |
MOVES TO THE NEXT PAGE OF A FORM |
| BAR |
BILLING AND ACCOUNT RECEIVABLE |
| PATIENT INQUIRY |
FUNTION 49 |
| INVOICE INQUIRY |
FUNCTION 7 |
| DICTIONARY INQUIRY |
FUNTIONS 13,ACTIVITY5 |
| WHAT IS AN HMO |
HEALTH MAINTENANCE ORGANIZATION |
| PATIENT MUST CHOOSE A PRIMARY CARE PHYSICIAN |
HMO |
| PATIENT WILL REQUIRE AUTHORIZATION FOR NON PCP SERVICES AND TO SEE A SPECIALIST |
HMO |
| OUT OF NETWORK SERVICES MUST BE PRE-AUTHORIZED |
HMO |
| PATIENT RESPONSIBILITY IS LIMITED PRIMARILY TO CO-AYS OR NON COVERED SERVICES. |
HMO |
| DEDUCTIBLE AND CO-INSURANCE DO NOT USUALLY APPLY |
HMO |
| ALL HMO'S IN CALIFORNIA ARE REGULATED BY DMHC |
HMO |
| PROVIVER ARE PAID A FIXED PER CAPITA(PER PERSON)AMOUNT FOR EACH PATIENT ENROLLED IN THE HMO OVER A STATED PERIOD OF TIME REGARDLESS OF THE TYPE AND # OF SRVCES PROVIDEDL |
CAPITATION |
| WE CHARGE AFEE FOR SERVICE PROVIDED,SUBMIT A CLAIM AND RECEIVE PAYMENT BASE ON THE CONTRACTED RATE. |
FEE FOR SERVICE/FFS |
| EXCLUSIVE PROVIDER ORGANIZATION |
EPO |
| DO NOT HAVE OON BENEFITS/NEED TO SELECT PMG THAT IS IN NETWORK. |
EPO |
| MUST UTILIZE IN NETWORK PROVIDERS IN ORDER TO RECEIVE BENEFITS. |
EPO |
| ASSUMPTIONS OF LIABILITY |
AOL |
| WHAT IS PP0? |
PREFFERRED PROVIDER ORGANIZATION |
| DO NOT HAVE TO CHOOSE A PCP OR PMG.CAN SEE ANY PROVIDER,BUT PATIENT RESPONSIBILITY ISHIGHER IF THEY CHOOSE A NON PREFFERED PROVIDER. |
PPO |
| DEDUCTIBLE,CO-PAYS AND COINSURANCE USUALLY APPLY. |
PPO |
| NO REFERRAL OR AUTHORIZATION NEEDED TO SEE SPECIALIST.HOWEVER,AUTHORIZATION FOR CERTAIN SERVICES SOMETIMES IS REQUIRED. |
PPO |
| WHAT IS A POINT OF SERVICE? |
POS |
| A MEMBER MAY SELECT A DIFFERENT PROVIDER (AND BENEFIT TIER) EACH TIME THEY SEEK MEDICAL CARE. |
POS |
| TIER 1 |
HMO PLAN |
| TIER 2 |
PPO PLAN |
| TIER 3 |
INDEMNITY/COMMERCIAL PLAN |
| THESE ARE PATIENTS THAT COME TO SCRIPPS BUT BELONG TO ANOTHER MEDICAL GROUP |
OON/OUT OF NETWORK |
| PATIENTS WHO COME FROM ANOTHER STATE AND SEEK TREATMENT |
OON/OUT OF NETWORK |
| PATIENTS WHO WANT A SECOND OPINION FOR SERVICES THAT THEIR PMG HAS RECOMMENDED. |
OON/OUT OF NETWORK |
| ANY TYPE OF INSURANCE THAT WE ARE NOT CONTRACTED WITH, |
COMMERCIAL OR INDEMNITY |
| PATIENT IS RESPONSIBLE FOR ANY BALANCE AFTER INSURANCE. |
COMMERCIAL |
| PATIENT MAY OR MAY NOT HAVE AUTHORIZATION REQUIREMENTS. |
COMMERCIAL |
| STATEMENT PRODUCING FSCS. |
COMMERCIAL |
| DEPARTMENT OF DEFENSEWIDE HEALTH CARE PROGRAM FOR ACTIVE DUTY AND RETIRED UNIFORMED SERVICES MEMBERS AND THEIR FAMILIES. |
TRICARE |
| 65 YEARS OF AGE AND OLDER,CERTAIN YOUNGER PEOPLE WITH DISABILITIE; AND PEOPLE WITH END-STAGE RENAL DISEASE. |
MEDICARE |
| A COVERAGE FOR ACUTE INPATIENT HOSPITALIZATION,SKILLED NURSING CARE,HOSPICE AND HOME HEALTH BENEFITS. |
MEDICARE PART A |
| A COVERAGE FOR OUTPATIENT CLINIC MEDICAL BENEFITS. |
MEDICARE PART B |
Beef Production
