terminology
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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| clearinghouse | an independent organization that recieves insurance claims from the physican's office, perform software edits and redistributes the claims electronically to various insurance carriers
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| code sets | any set of codes with their descriptions used to encode date elements such as tables or terms,medical concepts, medical diagnostic codes, or medical procedure codes
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| covered entity | an entity that transmits health information in electronic form in connective with a transaction covered by HIPAA
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| date elements | medical codes sets used uniformly to document why patients are seen and what is done to them during their encounter
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| digital subscriber line | a high speed connection through a telephone line jack and usually a means of accessing the internet
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| direct date entry | keying claim information directly into the layer system by accessing over modem dial up or DSL
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| electronic data interchange | the process by which understandable data items are sent back and forth via computer linkages between two or more entities that function alternatively as sender and reciever
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| electronic funds transfer | a paperless computerized system enabling funds to be debited, credited, or transferred, eliminating the need for personal handling of checks
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| electronic remittance advise | an online transaction about the status of a claim
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| encryption | to asign a code to represent data for sercuity purposes
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| HIPAA transaction and code set rule | this regulation under HIPAA defines the standardized methods for transmitting electronic health information
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| national standard format | the name of the standardization of data to reduce paper and have more accurate information and efficent organization
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| real time | online interactive communication between two computer systems allowing instant transfer of information
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| trading partner agreement | contract between the provider and a clearinghouse that submits the electronic claims on behalf of the provider
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| medical necessity | the performance of services and procedure that are consistant with the diagnosis in accordance with standards of good medical practice
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| root word | words used to look up the code correctly the first time for icd-9 disease signs and symptoms
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| chronic | a medical condition persisting over a long period of time
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| acute | a medical condition that runs a short but relatively severe course
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| encoder | add on software to practice management systems that can reduce the time it takes to build or review insurance claims before batch transmission to the carrier
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