MOP 130
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| Acute care | A facility that provides medical care and treatment to patients who require care for their acute condition, illness, or injury.
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| Encounter form | a listing of services and procedures for collecting charges for a patient's visit.
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| inpatient | a patient that requires a minimum 24 hour stay
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| outpatient | patient stays in the hospital for less than 24 hours
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| observation care | when patients need to be monitor closely to determine discharge status.
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| referring physician | The physician who "refers" the patient for admission.
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| assignment of benefits | A consent for any benefits or payments for services will be snet directly to the facility.
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| advance beneficiary notice | consent that identifies services not covered by patient's insurance in which they will be responsible for payment.
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| charge capturing | the gathering of charges and charge documents from all departments for billing purposes.
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| facility charge | a charge for sources use during a patient's stay.
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| releases of medical records form | A consent to release medical information to third party payer.
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| Emergency Medical Treatment Act | states that facilities are obligated to provide emergency medical access to all, regardless of their ability to pay.
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| Social Security Act 1965 | provides health care benefits to the elderly and low income population.
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| Hill-Burton ACT | it provides funding for hospital constructions.
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| COBRA | the ability to continue health Insurance coverage from your previous employer for your 90 day provisionary period of your new employer.
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| patient financial policy | expectation of payment due at the time of service, collection process, and statement that responsibility lies with the patient.
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| Medicare part A | covers inpatient hospital stays
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| Medicare part B | covers outpatient visits
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| CDM | Charge Description Master
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| RA | Remittance Advice
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| EOB | Explanation Of Benefits
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| SNF | Skill Nursing Facility
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| when it is acceptable to code for signs and symptoms ? | Diagnosis has not been establish by provider in the outpatient .
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| who performs audits and investigates fraudulent activities to protect the integrity of the Medicare and Medicaid programs? | (OIG) Office of inspector general
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| who oversees the Medicare and Medicaid programs for the federal government? | (CMS) Centers for Medicare and Medicaid Services
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| what is DHHS responsible for ? | Their responsible for controlling Health care cost
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| What does the NCQA known for ? | providing guidelines on how a facility selects providers
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| what is hospital size measure by? | bed count
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| when a document is charged in an EHR , the original documentation is ___________. | Hidden
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| what should an insurance and coding specialist do when checking for completion of a new patient's registration form? | check demographics are completed, make sure registration forms is sign and dated , make sure the patients name matches card.
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| what is the purpose of a utilization review department? | to make sure all health services provided to a patient are medically necessary.
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| when is the first contact with the patient made in the hospital revenue cycle? | during scheduling/appointments
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| what is a hospital revenue cycle ? | the process or cycle of managing claims, payments, and revenue .
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