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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 |
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