INTRO
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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| PHI | Patient info: demographics, identifying information, diagnoses, etc.
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| OIG | Identifies and combats waste, fraud, and abuse. Develops work plan to identify areas of focus for the upcoming year.
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| HIPAA | Law that protects patient privacy - Portability and Accountability Act
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| HMO | Type of insurance plan - select PCP, must stay in network, need referral for specialist visit
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| EPO | Type of insurance plan - no need to select PCP, must stay in network, no referral for specialist visit
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| PPO | Type of insurance plan - no need to select PCP, not required to stay in network, no referral necessary
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| Federal Register | Publication for rules, proposed rules, and notices of the Federal Government
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| CMS | Centers for Medicare and Medicaid Services - website includes manuals and guidelines for billing
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| MAC | Private health care insurer that processes Medicare claims - MACS vary by geographic location.
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| RVU | Value assigned to each code which represents cost for providing service.
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| Three components that make up RVU | Work involved, practice expenses (rent, etc.), and malpractice insurance.
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| Conversion Factor (CF) | Dollar multiplier that converts the RVU into an actual dollar amount.
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| GPCI (Geographic Practice Cost Indices | Accounts for differences in the cost of practice across the country according to location.
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| Medicare Part A | Hospital coverage
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| Medicare Part B | Supplementary coverage (office visits, etc)
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| Medicare Part D | Prescription drug coverage
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| Medicare Part C | Medicare Advantage Organizations (beneficiaries choose their providers & type of coverage)
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| CPT Book | Includes codes for all types of physician services - procedures, office visits, lab work, radiology, etc.
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| ICD-10 | Includes diagnosis codes
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| EMR | Electronic Medical Record
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| Fraud | The intentional deception or misrepresentation of information in order to receive unauthorized benefit
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| OBRA | Includes provisions establishing physician fee schedule, standard rates for increases, etc.
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| Medical Necessity | The reason for receiving medical services
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Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
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If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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Created by:
kducey
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