Exam 4 MBC116

50 terms by Kati1272 

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Questions and answeres to exam 4

does clearinghouse always charge a flat fee?

no

Practice management system can be rented...

true

a signed agreement by the physician is involved in order to transmit claims electronicly

true

even though dr's office does not bill medicare or transmit claims electronicly direct or by third party are they still subject to HIPPA standerds?

no

A medicare claim must include a standard code set ( CPT< ICD9)

yes

Batch

group of ins. claims sent @ same time from one facility

what is a clearinghouse?

entety that receives claims , performf edits before transmitting to ins. carriers

Where should backup copies of office records be kept?

away from office

ins. claims transmitted electronicly are usually paid......

with in 2 weeks

Ins. claim forms are gethared ?

before durring and after services are rendered

A clearing house is?

an entity that receives claim perfomes edits before transmitting to ins. carriers

Who assigns the employers ID number?

IRS

What is the most important function of a practice management system?

AR/ Accounts receivable

What is a carrier direct?

A med. Practice has it's own computer and transmits claims electronocly to the ins. carrier

What is an ins. billing worksheet?

A computer printout that is used to look for errors befor transmission of claims

What is an interactve transaction?

back and forth communication between user and computer durring online real time

When keying in data it is wise to.....

bakp up frequently

A status report of claims is usually received.....

electronicaly

Post payments in practice management systems.....

daily

Research unpaid claims....

weekly

Update practice management system with payer info......

end of the month

Correct rejections and submit claims....

daily

Revew clearinghouse/payer reports

daily

Make followup calls to resolve reason for rejection

Weekly

Audit claims Batched and transmitted with confirmation reports

daily

Review all claims rejection reports....

end of month

Batch, scrub, edit, and transmit claims...

daily or weekly

Note any problrmatic claims and resolve outstanding files

weekly

3 other names for encounter form

charge, transaction or routing slip

what are medical codes

data elemnet used uniformly to document as to why the p/t is being seen

CO

carbon monixide

CO2

carbon dioxid

BMT

bone marrow transplant

BE

barium enema

c/o

complaint of

BM

bowel movement

cc

cubic cnetimeter

CC

chief complaint

A&P

Auscultation and percution

AP

anteroposterior

BAL

bronchioalveolar lavage

BSE

breast self exam

BSO

bilateral salpingo -oophorectomy

B.i.d.

twice daily

oC

celcius, centigrade

AU

each ear

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