CODING CHAPTER 1 Word Scramble
|
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Term | Definition |
PHI | Patient info: demographics, identifying information, diagnoses, etc. |
OIG | Identifies and combats waste, fraud, and abuse. Develops work plan to identify areas of focus for the upcoming year. |
HIPAA | Law that protects patient privacy - Portability and Accountability Act |
HMO | Type of insurance plan - select PCP, must stay in network, need referral for specialist visit |
EPO | Type of insurance plan - no need to select PCP, must stay in network, no referral for specialist visit |
PPO | Type of insurance plan - no need to select PCP, not required to stay in network, no referral necessary |
Federal Register | Publication for rules, proposed rules, and notices of the Federal Government |
CMS | Centers for Medicare and Medicaid Services - website includes manuals and guidelines for billing |
MAC | Private health care insurer that processes Medicare claims - MACS vary by geographic location. |
RVU | Value assigned to each code which represents cost for providing service. |
Three components that make up RVU | Work involved, practice expenses (rent, etc.), and malpractice insurance. |
Conversion Factor (CF) | Dollar multiplier that converts the RVU into an actual dollar amount. |
GPCI (Geographic Practice Cost Indices | Accounts for differences in the cost of practice across the country according to location. |
Medicare Part A | Hospital coverage |
Medicare Part B | Supplementary coverage (office visits, etc) |
Medicare Part D | Prescription drug coverage |
Medicare Part C | Medicare Advantage Organizations (beneficiaries choose their providers & type of coverage) |
CPT Book | Includes codes for all types of physician services - procedures, office visits, lab work, radiology, etc. |
ICD-10 | Includes diagnosis codes |
EMR | Electronic Medical Record |
Fraud | The intentional deception or misrepresentation of information in order to receive unauthorized benefit |
OBRA | Includes provisions establishing physician fee schedule, standard rates for increases, etc. |
Medical Necessity | The reason for receiving medical services |
Created by:
kducey
Popular Medical sets