44 terms

Medical Office Billing I

Chapter 1 Introduction to Professional Billings and Coding Careers.
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Terms in this set (...)

Admitting Clerk
Clerk who enters patient's demographic information into a computer and obtains signed statement (s) from patients to protect hospitals' interests.
Centralized billing office (CBO)
Specializes in maintaining patient accounting records, filing health insurance claims, working with insurance carriers to receive reimbursement on insurance claims filed, and appealing denied claims.
Certifications
Training received in particular fields that acknowledges a medical office specialist's expertise.
Insurance Verification Representative
Coordinates all financial aspects of patient visits and admissions, including insurance verification, precertification information, follow-up of third-party payment denials, and financial counseling.
Medical biller
Individual who submits and tracks all insurance claims and ensures that insurance companies correctly reimburse the healthcare provider.
Medical coder
Individual who assigns numerical codes to diagnosis and procedures using the ICD-9 (10)-CM and CPT manuals.
Patient account services (PAS)
A facility that centralizes the process of billing patients and carriers for treatment received at an inpatient facility.
Registered health information technician (RHIT)
Coordinates services related to inpatient medical coding, medical documentation, abstracting, data, collection, and reimbursement requirements; supervises inpatient medical coding.
Four different types of facilities
Physician's practice, multi-specialty clinic, hospital, and centralized billing office.
Identify at least three job titles?
Medical office assistant, medical biller, medical coder, RHIT, payment poster, medical collector, refund specialist, insurance verification representative, admitting clerk or front desk representative, or a privacy compliance officer.
Medical office assistant certification
National certified medical office assistant (NCMOA), and certified medical administrative assistant (CMAA)
Medical billings certifications
Certified medical billing specialist (CMBS), and reimbursement specialist certification(CMRS)
Medical coding certifications
Certified coding associate (CCA), certified professional coder (CPC), certified professional coder-hospital (CPC-H), certified coding specialist (CCS), certified coding specialist-physician (CCS-P)
Medical records certification
Registered health information technician (RHIT)
T or F: PAS is an abbreviation for patient account services.
True
T or F: The medical office assistant might compile and record medical records, reports, and correspondence.
True
T or F: HIPAA is an abbreviation for Hospital Information per American Medical Association
False
T or F: Certification is not required in most states?
False
Math skills are important when working with refunds and posting of payments?
True
Coding accuracy is very important to healthcare organizations because funding cannot be received without accurate coding.
True
Registered health information technicians are health information technicians who ensure billing of medical records by verifying their completeness, accuracy, and proper entry into computer systems.
True
An admitting clerk may be responsible for appointment scheduling?
True
A collector may be required to send out patient billing statements.
True
A medical office assistant is considered front office staff and primarily handles administrative duties.
True
A business that contracts with physicians to handle its claims and or accounts receivable is referred to as a(n):
Centralized billing office
A person who is considered front office staff and primarily handles administrative duties is called a(n):
Medical secretary, medical office assistant, and medical receptionist.
A health information technician has the responsibility to:
Research and code medical records.
What job description requires excellent data entry skills, math skills, and a good working knowledge of insurance contracts?
Payment poster
A medical collector will contact most patients:
by telephone
A refund specialist position requires:
Researching, analytical, and math skills.
What job description routinely requires face-to-face contact with the patient?
Admitting clerk
Professional memberships help their members by:
Providing current information in their field.
An example of a certification agency is the:
American Health Information Management Association
What abbreviation stands for a coder who specializes in hospital coding?
CPC-H
What are 3 common sizes of physician practices?
Solo/private, small group, and large group
What are other job titles for a medical biller?
Billing specialist, and reimbursement specialist
As a medical collector, it is important to have what two qualities?
Patience and tact
The knowledge of (BLANK) and (BLANK) is imperative to perform well in all medical administration positions
billing and coding
A Medical office assistant may also be referred to as a medical (BLANK) or a medical (BLANK).
assistant, receptionist
The payment poster generally reads the (BLANK) from insurance carriers and posts the payments or contractual adjustments to the appropriate patient account.
Explanation of benefits document
An insurance verification representative will determine the patient's financial responsibility __________ to services being rendered.
required
Professional membership is an excellent addition to your __________.
resume
To receive the CPC-H certification, you must have _________ years of work experience and pass the certification exam.
two
The registered health information technician certification is awarded through the _________.
American health information management association (AHIMA).