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IHMO Ch 8 Key Term
Question | Answer |
---|---|
Accredited Standards Committee X12 (ASC X12) | The U.S. standards body formed by the American National Standards Institute (ANSI) for cross-industry development, maintenance, and publication of electronic data exchange standards. |
Application service provider (ASP) | A practice management system available over the Internet in which data are housed on the server of the ASP but the accounts are managed by the health care provider's staff. |
Backup | A duplicate data file: tape, CD-ROM, disk, or zip disk used to record data; it may be used to complete or redo the operation if the primary equipment fails. |
Batch | A group of claims for different patients from one office submitted in one computer transmission. |
Business associate agreement | Contract between the provider and a clearinghouse that submits the electronic claims on behalf of the provider. |
Cable modem | A modem used to connect a computer to a cable television system that offers online services. |
Clearinghouse | An independent organization that receives insurance claims from the physician's office, performs software edits, and redistributes the claims electronically to various insurance carriers. |
Code set | Any set of codes with their descriptions used to encode data elements such as tables of terms, medical concepts, medical diagnostic codes, or medical procedure codes. |
Covered entity (CE) | An entity that transmits health information in electronic form in connection with a transaction covered by HIPAA. |
Data elements | Medical code sets used uniformly to document why patients are seen (diagnosis, ICD-9-CM) and what is done to them during their encounter (procedure, CPT-4, HCPCS). |
Direct data entry (DDE) | Keying claim information directly into the payer system by accessing over modem dial-up or DSL. This is a technology to directly enter the information into the payer system via the access whether it is dial-up or DSL. |
Digital subscriber line (DSL) | A high-speed connection through a telephone line jack and usually a means of accessing the Internet. |
Electronic data interchange (EDI) | The process by which understandable data items are sent back and forth via computer linkages between two or more entities that function alternatively as sender and receiver. |
Electronic funds transfer (EFT) | A paperless computerized system enabling funds to be debited, credited, or transferred, eliminating the need for personal handling of checks. |
Electronic remittance advice (ERA) | An online transaction about the status of a claim. |
Encoder | An add-on software to practice management systems that can reduce the time it takes to build or review insurance claims before batch transmission to the carrier. |
Encryption | To assign a code to represent data. This is done for security purposes. |
HIPAA Transaction and Code Set (TCS) rule | This regulation defines the standardized methods for transmitting electronic health information. The TCS process includes any set of HIPAA-approved codes with their descriptions used to encode data elements. |
National standard format (NSF) | The name of the standardization of data to reduce paper and have more accurate information and efficient organization. |
Password | A combination of letters and numbers that each individual is assigned to access computer data. |
Real time | Online interactive communication between two computer systems allowing instant transfer of information. |
Standard transactions | The electronic files in which medical data are compiled to produce a specific format. |
T-1 | A T-carrier channel that can transmit voice or data channels quickly. |
Taxonomy codes | Numeric and alpha provider specialty codes that are assigned and classify each health care provider when transmitting electronic insurance claims. |
ANSI | American National Standards Institute |
ASET | administrative simplification enforcement tool |
ASP | application service provider |
ASC X12 | Accredited Standards Committee X12 |
ATM | automatic teller machine |
DDE | direct data entry |
DHHS | U.S. Department of Health and Human Services |
DSL | digital subscriber liner |
EDI | electronic data interchange |
EFT | electronic funds transfer |
EHR | electronic health record |
EMC | electronic medical claim |
EOMB | explanation of Medicare benefits |
ePHI | electronic protected health information |
ERA | electronic remittance advice |
HHS | U.S. Department of Health and Human Services |
IRS | Internal Revenue Service |
LMP | last menstrual period |
MTS | Medicare Transaction System |
NSF | National Standard Format |
PMS | practice management software, practice management system |
TCS | HIPAA transaction and code set |
UPS | uninterruptible power supply |