What is a non-physician practitioner?

Called NPP - a person who can see patients and prescribe medications (i.e. nurse practicioner, physician assistant, physical therapist, speech therapist, LCSW); have their own provider # and can submit claims to third party payers.

It is the amount of actual money available to the medical practice.

Completion of what is necessary for a job as a coder?

An accredited program for coding certification or an accredited health information technology program.

What is medical ethics?

Medical ethics are standards of conduct generally accepted as moral guides for behavior.

Who is known as the "Father of Medicine" and conceived the Oath of Hippocrates?

Hippocrates, a Greek physician - about 5th century BC.

In 1980 the American Medical Association (AMA) adopted what?

A modern code of ethics called the Principles of Medical Ethics.

Illegal coding is considered illegal activity which is subject to what?

Penalties, fines, and/or imprisonment and can result in loss of morale, reputation and good will of the community.

Reporting incorrect information to third party payers is what?

It is unethical, but may not be illegal depending on state laws.

The following is from the preamble of what organization: Health information management professionals strive for professional excellence through self-assessment and continuing education?

The American Health Information Management Association (AHIMA) code of ethics.

Physicians legal responsibility for the conduct and actions of their employees is called what?

Vicarious liability or respondent superior.

If an employee knowingly submits a fraudulent Medicare or Medicaid claim at the direction of the employer what can happen?

Both the employer and employee can be sued by the state or federal government.

An insurance biller should always check what?

Check with her employer to determine whether she is included in the medical professional liability insurance policy.

Among the things a medical biller will be expected to do is what?

Keep current and stay up-to-date by reading the latest health care industry association publications, participating in e-mail listserv discussions, joining a professional organization for networking, and attending seminars on billing and coding.

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Module 1: Chapter 1

Role of Billing Specialist

Question	Answer
What is a non-physician practitioner?	Called NPP - a person who can see patients and prescribe medications (i.e. nurse practicioner, physician assistant, physical therapist, speech therapist, LCSW); have their own provider # and can submit claims to third party payers.
The person who files and maintains health information records and distributes the mail to various departments within the office is called what?	File clerk
Insurance claims must be promptly submitted - ideally within how many business days to ensure continuous cash flow?	1 to 5
What is cash flow?	It is the amount of actual money available to the medical practice.
Completion of what is necessary for a job as a coder?	An accredited program for coding certification or an accredited health information technology program.
What is medical ethics?	Medical ethics are standards of conduct generally accepted as moral guides for behavior.
Who is known as the "Father of Medicine" and conceived the Oath of Hippocrates?	Hippocrates, a Greek physician - about 5th century BC.
In 1980 the American Medical Association (AMA) adopted what?	A modern code of ethics called the Principles of Medical Ethics.
Illegal coding is considered illegal activity which is subject to what?	Penalties, fines, and/or imprisonment and can result in loss of morale, reputation and good will of the community.
The Internet Healthcare Coalition has developed what?	An eHealth Code of Ethics.
Reporting incorrect information to third party payers is what?	It is unethical, but may not be illegal depending on state laws.
The following is from the preamble of what organization: Health information management professionals strive for professional excellence through self-assessment and continuing education?	The American Health Information Management Association (AHIMA) code of ethics.
Coding services or procedures that were not performed for payment is an example of what?	Illegal coding
Physicians legal responsibility for the conduct and actions of their employees is called what?	Vicarious liability or respondent superior.
If an employee knowingly submits a fraudulent Medicare or Medicaid claim at the direction of the employer what can happen?	Both the employer and employee can be sued by the state or federal government.
An insurance biller should always check what?	Check with her employer to determine whether she is included in the medical professional liability insurance policy.
Among the things a medical biller will be expected to do is what?	Keep current and stay up-to-date by reading the latest health care industry association publications, participating in e-mail listserv discussions, joining a professional organization for networking, and attending seminars on billing and coding.

Created by: mpeoples

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