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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
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
electronic claims can be processed by these before they are recieved by insurance companies
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
practice management program
a program that automates financial and administrative tasks is a medical practice
a service bureau that collects electronic claims from medical practices and forwards them to the appropriate health plans
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
process that leads to maximum, appropriate, timely payment for patients' medical services
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
payments of fixed amounts paid to physicians at regular intervals for providing services to plan members
patient data, transaction data
billing in medical offices depends on these two types of services (data)
title I- health insurance reform
Title of HIPAA regarding continuous insurance coverage for workers and their insured dependents when they change or lose jobs
transmits clinical data about the patient
a reason why a computer can be a life-saving device in an emergency
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
automated entry of information from a remittance advice into a practice management program
a big advantage of computerized scheduling is that it is easier to find these through a computer search
information technology IT
refers to the computer hardware and software that medical practices use to accomplish daily tasks
The practice must have this if they use an outside billing service to create and file claims
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
administrative, technical, physical
HIPAA security act outlines these safeguards required to prevent unauthorized access to protected healthcare information (3)
patients and transactions
computerized accounting system for informationin databases about these (2 things)
form that includes patients personal, employment and insurance data needed to complete an insurance claim
eliminates medication errors that result from illegible handwriting on prescription forms
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