Term | Definition |
HIT (Health Information Technology) | techology used to perform clinical tasks such as record vitals; it also preforms admin tasks such as creating insurance claims. |
PMP (practice management program) | software that automates admin tasks, mostly financial tasks |
daily tasks of PMPs | create, transmit, and monitor claims. Receive and process payments |
Monitoring claim status | Pmp can monitor and remind of payments; important for prompt payments |
Electronic health records | Lifelong file of healthcare over time for a Pt |
electronic prescribing | The use of computers and handheld devices to transmit prescriptions in digital format |
patient support | offers Pt information to prepare them |
factors that contribute to PT safety | -meds and dr errors minimal due to illegable hand writing eliminated
-dr get instant alerts for allergies & drug interactions
-dr get alerts when meds are pulled from market
-Records not lost in natural disasters
-info communicated in a timely manner |
efficiency factors in EHR | -Easier to find info
-Quicker, save time for pt and DR
-multiple ppl can work on EHR at same time
-prescribing meds |
Medical billing cycle | 10 stp process ensuring timely payments |
preregistering Pts | cheif complaint, contact info and medical history obtained; process # 1 of medical billing cycle |
Pt information form | a form that includes personal, employment, and medical insurance data needed to collect payments. |
ICD 9 & 10 - Diagnosis codes | international classification of disease. turns diagnosis to #s so they may be processed and billed corectly |
CPT- procedure codes | codes given for the procedures |
encounter form / superbill | a list of everything that took place during visit. |
claims information needed | what was done, what was used, and diagnosis of visit with documentation. must show medical nessecity |
REMITTANCE ADVICE | list amnts that has been paid on claims and why
-details about pt id# services provided, and date services provided |
OVERPAYMENT | when insurance overpays, the clinic is expects to refund the amount overpayed |
HIPAA | health insurance portability and accountability act of 1996, ensures insurance when moving from job to job, decrease fraud and abuse in health care-mandates standards for health info- ensures security and privacy |
REGIONAL EXTENSION CENTERS | Centers that offer information, guidance, training, and support services to providers transitioning to an EHR system |
GOAL OF HIE | to facilitate access to clinical information for the purpose of providing quality care to pts |
AFFORDABLE CARE ACT | increases access to health care, improves quality of healthcare, explores new models for delivery and payment. |