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Fordney Insurance HB

Ch 1

QuestionAnswer
What is cash flow? the amount of acual money available to the medical practice
What is a multiskilled health practitioner (MSHP)? an individual cross-trained to provide more than one function, often in more than one discipline
What is the role of a claims assistance professional(CAP)? they work for the consumer, helping patients organize, complete, file, and negotiate health insurance claims of all types to obtain maximum benefits, as well as tell patients how much to pay the providers to eliminate overpayment
Office procedures include: scheduling appointments, registering patients, documenting, charge entry, filing, bookkeeping and accounting.
Large accounts receivables (money owed for services rendered) is a direct result of: failure to verify insurance plan benefits, obtain authorization or precertification, or collect copayments and dedutibles or inadequate claims filifng.
The American Health Information Management Association (AHIMA) is: a national professional organization for promoting the art and science of medical record management and improving the quality of comprehensive health information for the welfare of the public.
The education requirements for entry into an insurance billing or coding specialist accredited program is: a high school diploma or GED.
Attribute of a proficient insurance claims specialist includes: expertise in medical terminology, anatomy, physiology, use of procedural/diagnostic code books, reading, math, medicolegal rules/regulations, compliance issues, computer, internet, billing and collections, legalities of collections, speed and accuracy.
To project a professional image, one must be attentive to: apparel and grooming.
Medical etiquette can be expressed as: consideration for others.
Medical ethics are: standards of conduct.
Are ethics the same as laws? No.
The Code of Hammurabi is: the earliest written code of ethical principles and conduct for the medical profession.
Who is the "Father of Medicine?" Hippocrates.
What is respondeat superior? "Let the Master Answer," which means the physician is responsible for their employees' actions (within the context of employment).
Does respondeat superior mean an employee cannot be sued? No. It means you both can be sued.
What can happen if you knowingly submit a false claim or allow such a claim to be submitted? You can be held liable.
If you mail or electronicallyfile a false claim: you may be implicated in mail or wire fraud.
What is a waiver of liability? A signed document used to relieve you of responsibility for questionable billing actions asked of you by the physician.
Created by: sabrinaf