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MA
anmistrative medicine
| Question | Answer |
|---|---|
| CPT - Current Procedural Terminology | Medical services Procedures performed by the provider |
| HCPCS - Healthcare Common Procedure Coding System | Supplies Procedures Services not described by CPT |
| ICD-10 - CM -- International Classification of Diseases, 10th revision, Clinical Modification | Diseases Injuries Medical conditions Patient status affecting health care Other reasons for health care encounters |
| Revenue cycle | The entire health care team has a direct impact on the potential revenue that will be earned and collected. Effective communication is important for revenue cycles |
| Incentive Models | include fee for service reimbursement but have added incentives based on the quality of the provider and the patients satisfaction ex. pay for performance, Accountable act organization, patient centered medical home |
| Auditing | done to ensure that documentation is complete and accurate, done so that claims can be correctly reimbursed |
| patient flow sheet | records and tracks patient health data such as vitals or labs |
| Encounter or super bill | Records the diagnosis and procedures covered during the current visit |
| encounter notes | clinical notes that include history of present illness and current medications list |
| cycle billing | billing in segments throughout the month |
| a clearing house provides | Claims adjudication for the third-party payer |
| A/R aging report | Accounts receivable (A/R) aging reports for a health care facility include any amount of money that is anticipated to be paid to them. An A/R aging report should be printed so that the older debts can be addressed first. |
| A/P aging report | Accounts paid (A/P) aging reports show money that will be paid out by the health care facility, not money owed to them. |
| Remittance advice | A remittance advice shows the results from claim adjudications. |
| Interoperability | Interoperability helps to ensure that health care organizations and professionals have all the important information needed regarding patient care. - supports the importance of documentation |
| copayment | Copayment is a predetermined set amount that is due at the time of services. |
| coinsurance | Coinsurance is a shared financial amount that has a percentage due by the patient and a percentage due by the third-party payer after the deductible has been met. |
| Deductible | The deductible is the annual amount that is paid by the patient before the third-party payer's financial responsibility is paid. |
| Write-off | A write-off is an amount that the health care facility deems to be noncollectible. |
| code for the reason the patient visted | Diagnosis codes (ICD-10-CM) |
| Advance Beneficiary Notice of Noncoverage | The Advance Beneficiary Notice of Noncoverage (ABN) is a form used for Medicare beneficiaries when the service may not be covered by a fee-for-service Medicare plan. |
| Notice of Privacy Practices | A Notice of Privacy Practices informs the patient of the expectations of the health care facility. |
Created by:
sylvia19
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