Administrative Office Procedures
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| Wave booking | show 🗑
|
||||
| show | Wave booking can be modified in a couple of different way. One example of this approach is to schedule 2 patients to come in at 9 am and 1 patients at 9:30 am. Hourly cycle repeats
🗑
|
||||
| show | Two patients are scheduled to come at the same time to see the same physician
🗑
|
||||
| Stream/Time-Specific scheduling | show 🗑
|
||||
| Open booking (tidal wave scheduling) | show 🗑
|
||||
| show | Booking a number of patients who have specific needs together at the same time of day.
🗑
|
||||
| matrix | show 🗑
|
||||
| show | Procedures to prioritize the urgency of a call to determine when the patient should be seen.
🗑
|
||||
| show | Legislation that includes Title II, the first parameter designed to protect the privacy and security of patient information.
🗑
|
||||
| electronic medical record (EMR) | show 🗑
|
||||
| show | Document that spells out what kind of treatment a patient wants in the event that he can't speak for himself/herself. Also known as a living will.
🗑
|
||||
| electronic health record (EHR) | show 🗑
|
||||
| birthday rule | show 🗑
|
||||
| show | Payment from insurance companies.
🗑
|
||||
| show | Added information or changed description of procedures and services and are a part of valid CPT or HCPCS codes.
🗑
|
||||
| show | Form that asks patients to list any illnesses or surgeries they have had, family history, medications taken, chronic health issues, allergies and other physicians they consulted.
🗑
|
||||
| show | Document informing a patient of when and how their PHI can be used.
🗑
|
||||
| show | A patient's permission.
🗑
|
||||
| patient financial responsibility form | show 🗑
|
||||
| show | Individually identifiable health information that is inputted, stored and shared relating to the health of patients.
🗑
|
||||
| assignment of benefits (AOB) form | show 🗑
|
||||
| living will | show 🗑
|
||||
| show | Form that states that the patient does not want to be revived after experiencing a heart episode or other kind of life-threatening event.
🗑
|
||||
| show | A health care professional who has been licensed by the state to provide and coordinate patient care.
🗑
|
||||
| urgent referral | show 🗑
|
||||
| show | Needed in an emergency situation, and can be approved immediately over the phone after the utilization review has approved the faxed document.
🗑
|
||||
| show | Section of medical charts for patients currently receiving treatment.
🗑
|
||||
| inactive files | show 🗑
|
||||
| show | Section of medical charts for patients who have died, moved away, or terminated their relationship with the physician.
🗑
|
||||
| purging | show 🗑
|
||||
| perpetual transfer method | show 🗑
|
||||
| provisional diagnosis | show 🗑
|
||||
| show | The process of weighing the probability that other diseases are the cause of the problem.
🗑
|
||||
| direct filing system | show 🗑
|
||||
| show | Reference to corresponding information in a separate location.
🗑
|
||||
| Privacy Rule | show 🗑
|
||||
| show | Documents or bits of information that identify the person or provider enough information so that the person could be identified.
🗑
|
||||
| show | Part of the offices accounting functions to include recording, classifying and summarizing financial transactions.
🗑
|
||||
| show | A set amount determined by the plan/payer that the patient pays for specified services, usually office visits and emergency department visits (usually collected at the time of service).
🗑
|
||||
| encounter form | show 🗑
|
||||
| deductible | show 🗑
|
||||
| coinsurance | show 🗑
|
||||
| show | A record of a patient's fees.
🗑
|
||||
| accounts receivable ledger | show 🗑
|
||||
| show | The limit that most insurance plans put on the amount that will be allowed for the reimbursement for a service or procedure.
🗑
|
||||
| resource-based relative value scale (RBRVS) | show 🗑
|
||||
| show | Person or entity responsible for the remaining payments of services after insurance has paid.
🗑
|
||||
| petty cash fund | show 🗑
|
||||
| show | The record of the funds distributed to specific expense accounts.
🗑
|
||||
| show | A chronological record of the bills rec'd, bills paid and payments and reimbursements received.
🗑
|
||||
| day sheet | show 🗑
|
||||
| end-of-day summary | show 🗑
|
||||
| single-entry system | show 🗑
|
||||
| show | Document where transactions are entered.
🗑
|
||||
| double-entry bookkeeping | show 🗑
|
||||
| subsidiary journals | show 🗑
|
||||
| show | The properties owned by a business.
🗑
|
||||
| equities | show 🗑
|
||||
| liabilities | show 🗑
|
||||
| show | A document that describes items purchased or services rendered and shows the amount due.
🗑
|
||||
| statement | show 🗑
|
||||
| first-class mail | show 🗑
|
||||
| priority mail | show 🗑
|
||||
| standard mail | show 🗑
|
||||
| insured mail | show 🗑
|
||||
| show | Mail of all classes protected by registering and requesting evidence of it's delivery.
🗑
|
||||
| show | First-class mail that also gives the mail added protection by offering insurance, tracking and return receipt options.
🗑
|
||||
| show | A list of items in a package.
🗑
|
||||
| covered entities | show 🗑
|
||||
| show | Organizations that use, collect, access and disclose individually identifiable health information, but do not transmit electronic data. These do not have to comply with the Privacy Rule.
🗑
|
||||
| show | Make private or sensitive information known.
🗑
|
||||
| show | Individuals, groups or organizations, who are not members of a covered entity's workforce, that perform functions or activities on behalf of a covered entity.
🗑
|
||||
| show | Secondary use of PHI that cannot be reasonably prevented, is limited in nature, and occurs as a result of another use or disclosure that is permitted.
🗑
|
||||
| electronic data interchange (EDI) | show 🗑
|
||||
| show | Unique 10 digit code for providers required by HIPAA.
🗑
|
||||
| show | Rule that describes safeguards that must be in place to protect the confidentiality, integrity and availability of health information stored in a computer and transmitted across computer networks, including the Internet.
🗑
|
||||
| firewall | show 🗑
|
||||
| audit trail | show 🗑
|
||||
| show | System that enables the sharing of health-related information among providers according to nationally recognized standards.
🗑
|
||||
| Occupational Safety and Health Administration (OSHA) | show 🗑
|
||||
| show | Plan that describes tasks employees must perform if there is a risk of exposure to blood or other potentially infectious materials, and what procedures are in place to track employee exposures.
🗑
|
||||
| show | Making false statements of representations of material facts to obtain some benefit or payment for which no entitlement would otherwise exist.
🗑
|
||||
| upcoding | show 🗑
|
||||
| show | Using multiple codes that describe different components of a treatment instead of using a single code that describes all steps of the procedure.
🗑
|
||||
| show | Practices that, either directly or indirectly, result in unnecessary costs to government-funded programs.
🗑
|
||||
| show | The documented need for a particular medical intervention.
🗑
|
||||
| show | A completion of information about fraud and abuse.
🗑
|
||||
| Healthcare Fraud and Abuse Program (HCFAP) | show 🗑
|
||||
| show | Medicare supplemental health insurance for Medicare beneficiaries, which may include payment of Medicare deductibles, coinsurance, balance bills or other services not covered by Medicare. Private health ins. pays for most of the charges not covered by A&B
🗑
|
||||
| Healthcare Common Procedures Coding System (HCPCS) | show 🗑
|
||||
| show | A list of guarantees for people receiving medical care.
🗑
|
||||
| referral | show 🗑
|
||||
| show | A patient and provider work together to decide on a treatment plan.
🗑
|
||||
| show | Discontinuing medical care without giving the proper notice or providing a competent replacement.
🗑
|
||||
| Blue Cross Blue Shield plan | show 🗑
|
||||
| inflection | show 🗑
|
||||
| jargon | show 🗑
|
||||
| template | show 🗑
|
||||
| complimentary closing | show 🗑
|
||||
| implied consent | show 🗑
|
||||
| show | Consent for treatment given out loud in response to a pointed question.
🗑
|
||||
| show | An oral or written agreement of mutual communication that ensures the patient has been notified about their health care choice before making them. Providers explain medical or diagnostic procedures, surgical interventions & the benefits & risks involved.
🗑
|
||||
| assault and battery | show 🗑
|
||||
| emancipated minor | show 🗑
|
||||
| Medicare Summary Notice (MSN) | show 🗑
|
||||
| show | Health insurance subsidized through premiums paid directly to the company.
🗑
|
||||
| premium | show 🗑
|
||||
| Medicare | show 🗑
|
||||
| benefit period | show 🗑
|
||||
| Medicare Part A | show 🗑
|
||||
| Medicare Part B | show 🗑
|
||||
| Medicare Advantage (MA) | show 🗑
|
||||
| health maintenance organization (HMO) | show 🗑
|
||||
| show | Plan that allows patients to use physicians, specialists and hospitals in the plan's network and receive a greater discount on services.
🗑
|
||||
| private fee-for-service plan | show 🗑
|
||||
| fee-for-service | show 🗑
|
||||
| Advance Beneficiary Notice of Noncoverage (ABN) | show 🗑
|
||||
| Medicare Part D | show 🗑
|
||||
| out-of-pocket maximum | show 🗑
|
||||
| Medicaid | show 🗑
|
||||
| State Children's Health Insurance Program (SCHIP) | show 🗑
|
||||
| managed care organization | show 🗑
|
||||
| show | A managed care method of monthly payments to the provider based on the number of enrolled patients, regardless of how many encounters a patient may have during a month.
🗑
|
||||
| show | Formal approval from the insurance company that will cover the test or procedure. Sometimes required by a payer to determine medical necessity for the proposed services.
🗑
|
||||
| show | A network of physicians, other health care practitioners & hospitals that have joined together to contract with insurance companies, employers or other organizations to provide health care to subscribers for a discounted fee.
🗑
|
||||
| show | Insurance that is tied to an individual's place of employment.
🗑
|
||||
| encrypted | show 🗑
|
||||
| administrative services only (ASA) contract | show 🗑
|
||||
| Hippocratic Oath | show 🗑
|
||||
| SOAP | show 🗑
|
||||
| show | It divides the medical record into four sections:
P=Problem
O=Oriented
M=Medical
R=Record
🗑
|
||||
| CHEDDAR | show 🗑
|
||||
| show | Term formed from a name.
🗑
|
||||
| show | Engaging with the sender regarding the message and the intended interpretation (focus solely on the conversation, do not interrupt, confirm the message speaker has said, be respectful and professional).
🗑
|
||||
| show | Administrative policies, procedures, and actions put in place to protect the privacy of the electronic health records.
🗑
|
||||
| advance directives | show 🗑
|
||||
| show | A report that lists outstanding balances that have not been paid by either the patient or the insurance payer.
🗑
|
||||
| anatomy and physiology | show 🗑
|
||||
| biases | show 🗑
|
||||
| show | Grouping similar patient conditions at specific times.
🗑
|
||||
| show | Medical services that are not included in the contracted capitation rate. These services may be billed separately.
🗑
|
||||
| show | Trained in both clinical and administrative duties.
🗑
|
||||
| show | Provides administrative support in a variety of health care settings including answering telephones, making appointments, checking patients in and out for examinations, collecting copayment as well as many other duties.
🗑
|
||||
| Clearinghouse | show 🗑
|
||||
| show | Sending and receiving information, thoughts, or feelings through verbal words, written words or body language.
🗑
|
||||
| show | Following mandated laws, policies, standards, and guidelines.
🗑
|
||||
| contracts | show 🗑
|
||||
| coordination of benefits (COB) | show 🗑
|
||||
| show | Various beliefs, languages, and practices that are unique to members of a specified group (ethnicity, race, national origin).
🗑
|
||||
| demographics | show 🗑
|
||||
| diversity | show 🗑
|
||||
| show | Time when the computer system is not functional and other processes must temporarily suffice.
🗑
|
||||
| show | Meeting the stipulated requirements to participate in the health care plan.
🗑
|
||||
| show | The ability to understand the perspective, drives, and experiences of another person.
🗑
|
||||
| established patients | show 🗑
|
||||
| show | Set of principles that differentiate between right and wrong.
🗑
|
||||
| show | Storage, exchange, accessibility and integration of health care records for the overall purpose of optimizing the health of individuals and populations.
🗑
|
||||
| Health Insurance Portability and Accountability Act (HIPAA) | show 🗑
|
||||
| health risk assessment | show 🗑
|
||||
| show | The primary goal of hospice is to help relieve uncomfortable symptoms in terminally ill patients. Relieving stress and making the patient comfortable are secondary goals. Hospice usually can be initiated at any stage of the terminal illness.
🗑
|
||||
| in-network | show 🗑
|
||||
| interval | show 🗑
|
||||
| licensed practical nurse (LPN) | show 🗑
|
||||
| malpractice | show 🗑
|
||||
| show | Laws that explain the rights and responsibilities of medical providers and patients.
🗑
|
||||
| show | A health care specialist who has a concentration or emphasis on a specific are of medicine.
🗑
|
||||
| show | A combination of Latin and Greek language used to describe components and processes of the human body, medical procedures, diseases, disorders and pharmacology.
🗑
|
||||
| Medicare abuse | show 🗑
|
||||
| show | Intentionally submitting false medical claims for payment, receiving incentives for medical services or devices that are federally funded, or making inappropriate referrals.
🗑
|
||||
| show | Program that focuses on transforming health care by recognizing patients safety issues and gathering data to support the progress in correcting these issues.
🗑
|
||||
| show | When a patient does not receive adequate and appropriate care, which leads to suffering and harm.
🗑
|
||||
| show | Courtesy rules for effectively communicating using an online format.
🗑
|
||||
| new patients | show 🗑
|
||||
| non-participating (non-PAR) provider | show 🗑
|
||||
| nonverbal communication | show 🗑
|
||||
| show | A registered nurse who possesses additional preparation and skills and is supervised by a physical examination, order and interpret tests, develop treatment plans, and prescribe medications.
🗑
|
||||
| show | Agrees to accept the payer's allowed amount (regardless of the billed amount). This may be referred to as in-network for managed care payers.
🗑
|
||||
| show | Form of malpractice that occurs when a provider stops treating a patient without a reasonable cause and/or without reasonable notice.
🗑
|
||||
| show | A partnership between a patient and their care team in which total health is the focus and not just a single condition. Health care team consists of a provider(physician, NP, PA), CMAA, CCMA, nurses & pharmacists.
🗑
|
||||
| show | A reimbursement model intended to improve the traditional fee-for-service method by changing the focus to value-based care rather than volume-based care.
🗑
|
||||
| show | The policies, procedures, and actions used to protect the computers and equipment from hazards and unauthorized access.
🗑
|
||||
| show | Licensed health care provider who works independently with physicians to diagnose illnesses, conduct physical examination, order and interpret tests, develop treatment plans and prescribe medications.
🗑
|
||||
| policyholder | show 🗑
|
||||
| practice management software | show 🗑
|
||||
| show | An efficient way to electronically manage administrative function, such as scheduling appointment, integrating patient documentation from EHRs, coding, billing, and revenue cycle tasks such a running aging reports and managing the accounts receivable.
🗑
|
||||
| show | A request to determine if a service is covered by the patient's policy.
🗑
|
||||
| show | The medical organizations and provider's norms.
🗑
|
||||
| primary care provider | show 🗑
|
||||
| show | The insurance plan responsible for paying health care insurance claims.
🗑
|
||||
| professionalism | show 🗑
|
||||
| protocols | show 🗑
|
||||
| referral | show 🗑
|
||||
| remittance advice | show 🗑
|
||||
| revenue cycle | show 🗑
|
||||
| show | A specific set of standards that a medical professional may perform within the limits of the medical license, registration, and/or certification.
🗑
|
||||
| show | Gathering pertinent health and insurance information.
🗑
|
||||
| secondary insurance | show 🗑
|
||||
| show | Technology and polices that protect electronic protected health information from being accessed by those without permission.
🗑
|
||||
| telehealth | show 🗑
|
||||
| telephone etiquette | show 🗑
|
||||
| show | Insurance coverage in addition to primary and secondary insurance. Tertiary insurance covers gaps in primary and secondary insurance coverage.
🗑
|
||||
| show | Accrediting body-focuses on quality improvement & patient safety, certifying health care organizations & programs in the US incl: hospitals & health care organizations providing ambulatory & office-based surgery, behavioral health, home health, labs & NH
🗑
|
||||
| show | Interaction between a patient and a medical professional focused on improving the physical and emotional well-being of the patient.
🗑
|
||||
| time-specified scheduling | show 🗑
|
||||
| show | The length of time from the date of service in which a health care organization may submit a claim to the third-party payer. Timely filing varies by payer and may range from 90 days to one year from D of S. Claims that exceed timely filing are not payable
🗑
|
||||
| urgent | show 🗑
|
||||
| show | Rewards the provider with incentive payments for meeting defined program performance standards.
🗑
|
||||
| verification | show 🗑
|
||||
| workflow | show 🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
Danielle Mulhern
Popular Medical sets