abbv & term
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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| AEP'S | Appropriateness evaluation protocols
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| PPS | Prospective payment system
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| SI | Severity of illness
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| ER | Emergency Room
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| PAT | Preadmission testing
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| DGR | Diagnosis Related Group
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| QIO | Quality Improvement Organization
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| CDM | Charge description master
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| MDC'S | Major diagnostic categories
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| STSG | Split thickness skin graft
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| FTSG | Full thickness skin graft
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| ORIF | Open reduction internal fixation
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| VBAC | Vaginal birth after cesarean
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| PE | Pressure equalization 2
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| IS | Intensity of service
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| Admission Review | A review of appropriateness and necessity of admissions
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| Capitation | A system of payment used by mangaed care plans in which physicians and hospitals are paid a fixed per capita amount for each patient enrolled over a stated period of time
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| Charges | The dollar amount a hospital bills an outlier case on the basis of the itemized bill
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| Code sequence | the correct order of diagnostic codes when submitting an insurance claim that affects maximum reimbursement
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| Comorbidity | An on going condition that exists along with the condition for which the patient is receiving treatment
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| In patient | A term used when a patient is admitted to the hospital for over night stay
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| Looping | The automated grouper process of searching all listed diagnosis for the presence of any comorbid condition of complication
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| Outpatient | A patient who receives services in a health care facility and goes home the same day
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| Per Diam | A single charge for a day in the hospital regardless of any actual charges or costs incurred
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| Procedure Review | A review diagnostic and therapeutic procedures to determine appropriateness
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| Principal Diagnosis | A condition established after study that is chiefly responsible for the admission of the patient to the hospital
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| Scrubbing | The process in which computer software checks for errors before a claim is submitted to an insurance carrier for payment
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| Stop Loss | A form of gerinty that may be written into a contract used to limit the exposure of cost to a reasonable level to prevent excessive loss
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| Transfer Review | Review of transfer to different areas of the same hospital that are exempted from prospective payment
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| Mastectomy | Surgical removal of the breast
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| Closed treatment | Surgical procedure does not involve surgically opening the site of the fracture for the purpose of repair
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| Open treatment | Procedure involves surgical opening of the site and visualization of the fracture for repair and treatment
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| Preadmission Testing | Treatment, tests, and procedure done 48-72 hours before admission of a patient into the hospital
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| Readmission Review | A review of patients readmitted to a hospital within 7 days problems related to the first admission to determine whether the first discharge was premature or the second admission is medically necessary.
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