IHMO chapter 8

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terms and abbreviations

accredited standars committee x12

the U.S. standards body formed by the American National Standards Institute for cross-industry development, maintenance, and publication of electronic data exchange standards

application service provider

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 providers staff

back up

a duplicate data file

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 clams electronically to various insurance companies

code sets

any set of codes with their descriptions used to encode date elements such as tables of terms, medical concepts, medical diagnostic codes, or medical procedure codes

covered entity

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 and what is done to them during their encounter procedure

digital subscriber line

a high-speed connection through a telephone line jack and usually a means of accessing the internet

direct data entry

keying claim information directly into the payer system by accessing over modem dial-up or DSL

electronic data interchange

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

a paperless computerized system enabling funds to be debited, credited, or transferred, eliminating the need for personal handling of checks

electronic remittance advice

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 rule

this regulation under HIPAA defines the standardized methods for transmitting electronic health information

national standard format

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

ASC x12

Accredited Standards Committee x12

ASET

administrative simplification enforcement tool

ASP

application service provider

ATM

automatic teller machine

DDE

direct data entry

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

MTS

medicare transaction system

NSF

nonsufficient funds

PMS

practice management software, practice management system

TCS rule

HIPAA transaction and code set

UPS

uinterruptible power supply

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