Must be included when billing an insurance company:
DOS, POS, TOS, and dx or DX
under what rule mays use patients Protected Health Information (PHI) with out specific authorization for treatment, payment, and operation purposes (TPO).
What does (T)reatment in TPO mean?
primarily for the purpose of discussion of the patients case with other providers
What does (P)ayment in TPO mean?
where providers submit claims on behalf of patients
What does (O)perations in TPO mean?
for purposes such as staff training and quality improvement
physicians are legally responsible for their own conduct and any actions of their employees.
"errors and omissions insurance" a protection against a loss of monies caused by failure through error or unintentional omission on the part of the individual or service submitting the insurance claim
Let the master answer
means an employee can be sued and brought to trial
: documentation on the patients social and medical history, family history, physical examination findings, progress notes, radiology and lab results, consultation reports and correspondence to patient
Reason 1 for Documentation of Pt Records
avoiding denied payments by insurance carriers investigating the medical necessity of services
Reason 2 for Documentation of Pt Records
enforcement of record keeping rules by insurance carriers requiring accurate documentation that supports procedure and diagnostic codes
Reason 2 for Documenting of Pt Records
Subpoena of medical records by state investigators of the court review
Reason 4 for Documenting of Pt Records
Defense of a professional liability claim
a M.D. must keep living Pt records for
a MD must keep deceased Pt records for
bursting forth of bloos
process of recording
front surface of the body
back side of the body
above another structure
below another structure
near the point of attachment to the trunk
far from the point attachment to the trunk
pertaning to the middle of the body
pertaining to the side
vertical plane diving the body by the front and the back
vertical plane diving the body by the right to left sides
horizontal plane dividing the body into upper and lower portions
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