Ch 1 questions
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| list ten steps of medical billing process | 1.preregister pt 2.establish $ responsability 3.chek in pt 4.review coding complience 5.review billing compliance 6.check out pt 7.prepare & transmit claims 8.monitor payer adjudication 9.generate patient statments 10. follow up payments & collections
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| what does ICD-9(or10)-CM stand for? | international classification of diseases (9th or 10th revision)-Clinical modification.
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| how are ICD-9&10-CM used? | they are used to code a diagnosis so that they can be sent and reviewed for payment by insurance companies
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| what does CPT stand for? | current procedural technology
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| When is CPT used? | used to report medical procedures and services.
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| what is the purpose of coding? | allows info to be used between drs, office personell health plans and so on without losing the precise meaning
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| what is a diagnosis? | the Drs opinion on the nature of the ilness or injury of the pt
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| what are procedures? | services performed
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| what are the advantages of EHR? | makes reporting easier 4 studies, past and present pt info dr uses to diagnos and treat.
helps dr make informed decision.
ability to order tests and meds. decision support. communication between DR.// Continuity of care.
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| whats the difference between EHR, EMR, PHR? | EHR is a whole life record, EMR is for 1 pt/1dr, PHR is a record the pt creates, maintains, and owns.
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| whats is a pmp? | Practice management programs, software that automates admin task
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| what information is found on a PT information sheet | personal, employment, and medical insurance data
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| what is an encounter form and what info does it contain? | its a form containing what was done during the visit
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| what is a clearinghouse? | its a party between dr office and insurance that reviews claims before insurance companies receive claims.
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| describe RAs and EOBs and tell the difference | remittance advice is provided directly to the health-care provider, whereas the explanation of benefits statement is sent to insured patient.
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| what does HIPAA stand for and what does it accomplish? | health insurance portability and accountabiliy act, ensures privacy and security of health info
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| what is PHI? | protected health info used to identify pts
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| what are the 3 security standards under the HIPAA Security Rule? | PHI is created, received, maintained or transmitted across a network
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| Define HITECH | Health Information Technology for Economic and Clinical Health Act encourages clinics to use technology for healthcare through reimbersments
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| What is meaningful use and what are the incentives to DR for its implementation? | they get money if they ACUTUALLY use the electronic system
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| what is ACA? | affordable care act increases health care improves quality and explores new models for delivery and payment
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| whats is PCMH and what are the core features? | Patient-Centered Medical Home; quality safety and efficiency
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| what is the benefit of monitoring claim status? | to ensure timely payment
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| what are the core functions of EHRs? | health info & data elements, results mgmt, order mgmt, decision support, communication and connectivity, pt support, admin process, reporting population health.
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| what is needed for an insurance company to make payment on a claim? | info about pt, procedures, diagnosis, date and location
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| what are advantages of EHRs? | safety quality and efficiency
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| Define HIE | health info exchange is the use of a network to exchange information between drs
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| Define electronic prescribing | the use of computers or hand held devices to place prescription order
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| refine RECs | reginal extension centers, help line to train and prepare clinics to adopt EHR
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