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Computers In The Medical Office Chapter 1

computers in the medical office chapter 1
STUDY
PLAY
1996
The year HIPAA was put into action?
email
medical offices use these to send reports, forms and other documents?
tricare
Insurance program that provides coverage for dependents of active duty service members
electronic
The least expensive way to submit claims
audit/edit
this report lists errors on electronic claims before they are transmitted to health plans
office of inspector general
The entity that threat criminal issues for complaints or non-compliance of HIPAA regulations are referred
e-commerce
medical practices participate in this to purchase supplies over the Internet at discount prices
preferred providor organization
Members of these plans usually pay a higher fee if they receive care from a physician outside network
clearinghouse
electronic claims can be processed by these before they are recieved by insurance companies
accounting cycle
The flow of financial transactions in a business
psychotherapy notes, records in legal proceedings, CLIA protected information
The three types of PHI that the patient does NOT have the right to access
Health Information Management HIM
People in this field work with administative and clincial computer systems
copayments
these are collected at the time of service
HIPAA compliant
Clearinghouses format electronic claims into this format
3rd party payer
an insurance carrier; can be private or public (3 words)
health insurance portability and accountability act
The meaning of HIPAA?
practice management program
a program that automates financial and administrative tasks is a medical practice
preferred provider organization
the most common type of managed care plan
clearinghouse
a service bureau that collects electronic claims from medical practices and forwards them to the appropriate health plans
patient information form
a new patient should always complete one of these forms
verifying ID of individual
An example of an Administrative Safeguard under the Security Rule
they process large amounts of information more efficiently
the use of computers in the medical office has led to significant increases in productivity due to this reason
medicaid
insurance provided for people with low incomes
billing process
process that leads to maximum, appropriate, timely payment for patients' medical services
audit trail
these are created to ensure the accuracey of medical data input into the computer
notice of privacy practices
the statement availabe to the patient at their first appointment that outlines individual's rights and covered entity's legal duties in regards to PHI
electronic funds transfer EFT
the capability to deposit insurance payments directly into a practice's account via computer
passwords
many offices assign these to limit access to healthcare information stored on a computer
ICD-9
you can find diagnosis codes in this book
RA
similar to an EOB
lab results, x-ray films, paper records
three examples of PHI
capitation
payments of fixed amounts paid to physicians at regular intervals for providing services to plan members
audit trail
keeps track of data entry on a computer and can be reviewed if security problem arises
procedure CPT
a standardized code that specifies the services the physician provided
medicare
provides coverage for persons 65 and older, persons with disabilities and dependent widows
computer password
An example of a technical safeguard under the HIPAA Security Rule
patient data, transaction data
billing in medical offices depends on these two types of services (data)
speed of transmission, less chance of errors, reduced costs
Advantages of using electronic claims
AMA
CPT was developed by this organization
title I- health insurance reform
Title of HIPAA regarding continuous insurance coverage for workers and their insured dependents when they change or lose jobs
dob, demographic, patient name
three examples of IIHI
collection process
when patient payments are overdue, this is started to collect on the account
transmits clinical data about the patient
a reason why a computer can be a life-saving device in an emergency
medical necessity
established when the diagnosis and treatment of a patient are logically connected
title II- administrative simplification
Title of HIPAA regarding the uniform sets of standards that protect and place limits on how confidential health information is used
locking cabinets
example of a physical safeguard under the HIPAA Security Rule
autoposting
automated entry of information from a remittance advice into a practice management program
appointments
a big advantage of computerized scheduling is that it is easier to find these through a computer search
coding
translates a description of a medical condition into a shorter, standardized code
pre-registering patients
First step in billing cycle
accounts receivable
money coming in to the practice
policy holder
medical insurance represents a contract between this and a health plan
837p
electronic claim format used to bill for a physician's service
information technology IT
refers to the computer hardware and software that medical practices use to accomplish daily tasks
contract
The practice must have this if they use an outside billing service to create and file claims
statement
lists the services performed for a patient, along with the charges for each service
electronic medical records
these can be access from several locations at the same time
day sheet
a report that lists charges, payments and adjustments during a day
insurance has a contract with provider for certain amount for each service, provider agrees/accept that amount as payment for service
The provider's fee schedule is not often the same as the insurance fee schedule. Why not?
consumer driven health plan CDHP
This type of health plan is a high deductible/low premium type of managed care plan
electronic medical record EMR
used to record clinical data
administrative, technical, physical
HIPAA security act outlines these safeguards required to prevent unauthorized access to protected healthcare information (3)
co-insurance
a PORTION of charges that are patient's responsibility
encounter form
also known as a superbill
EMR
unlike the paper form, these do not use a lot of physical space in the office
computerized
these billing programs reduce data entry errors
patients and transactions
computerized accounting system for informationin databases about these (2 things)
patient information
form that includes patients personal, employment and insurance data needed to complete an insurance claim
electronic prescribing
eliminates medication errors that result from illegible handwriting on prescription forms
all healthcare facilities
HIPAA pertains to these