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HIT Chap 16 terms

Administrative Simplification and Compliance Act (ASCA) an act under HIPAA that requires health plans and healthcare clearinghouses to use a certain standard transaction formats and code sets for the electronic transmission of health information
Billing Services companies that offer services to health care facilities that include billing processes and claims filing
Direct Data Entry Claims (DDE) claims that are submitted directly to the insurance carrier
Electronic Claims Clearinghouse a business entity that receives claims from several medical facilities and consolidates these claims so that one transmission containing multiple claims can be sent to each insurance carrier.
Electronic Data Interchange (EDI) the electronic transfer of information in a standard format between two entities
Electronic Funds Transfer (EFT) a system wherein money is moved electronically between accounts or organizations
Electronic Medical Record (EMR) an electronic file wherein patients’ heath information is stored in a computer system
Electronic Remittance Advice (ERA) electronic form sent by Medicare to the provider that explains how payment was determined for the claim.
Enrollment process process which medical offices usually must go through before they can submit claims to an insurance carrier.
Identifiers numbers used in the administration of health care to distinguish individual health care providers, health plans, employers, and patients
Privacy Standards define what are appropriate and inappropriate disclosures of individually identifiable health information
Telecommunication the transmission of claim information over phone line using a computer and a modem
Created by: Alyshia