24 terms

Electronic Data Interchange: Transactions and Security ch. 8 key terms

Accredited Standards Committee X12
ASC X12, The U.S. standards body formed by the American National Standards Institute (ANSI) for cross-industry develpment, maintenance, and publication of electronic data exchange standards
application service provider
ASP, A practice management syhstem available over the Internet in which data are housed on the sever of the ASP but the accounts are managed by the health care provider's staff.
back up
A duplicate data file: tape, CD-ROM, disk, or zip disk used to record data; it may be used to complete or redo the operation if the primary equipment fails.
A group of claims for different patients from one office submitted in one computer transmission
business association agreement
Contract between the provider and a clearinghouse that submits the electronic claims on behalf of the provider.
cable modem
A modem used to connect a computer to a cable television system that offers online services
An independent organization that receives insurance claims from the physician's office, performs software edits, and redistributes the claims electronically to various insurance carriers
code sets
Any set of codes with their descriptoins used to encode data elements, such as tables of terms, medial concepts, medical diagnostic codes, or medical procedure codes.
covered entity
An entity that transmits health informatoin in electronic form in connection with a transaction covered by HIPAA. the covred entity may be 1. a health care carrier such as Blue Cross/Blue Shield, 2. a health care clearing house through which claims are submitted, or 3. a health care provider such as the primary care physician
data elements
Medical codes sets used uniformly to document why patients are seen (diagnosis, ICD-9-CM) and what is done to them during their encounter (procedure, CPT-4, HCPCS).
digital subscriber line
DSL, A high speed connection through a telephone line jack and usually a means of accessing the Internet.
direct date entry
DDE, Keying claim information directly into the payer system by accessing over modem dial-up or DSL. This is technology to directly enter the information into the payer system via the access whether it it dial-up or DSL
electronic data interchange
EDI, The process by which understandable data items are sent back and forth via computer linkages between two or more entities that function alternatively as sender and receiver.
electronic remittance advice
ERA, An online transaction about the status of a claim
An add-on software to practice management systems that can reduce the time it takes to build or review insurance claims before batch transmission to the carrier.
To assign a code to represent data. This is done for security purposes
HIPAA Transaction and Code Set Rule
TCS, This regulation under HIPAA defines the standardized methods for transmitting electronic health information. The TCS process includes any set of HIPAA-approved codes with their descriptions used to encode data elements, such as tables of terms, medical concepts, medical diagnostic codes, or medical procedure codes. TCS regulations were implemented to streamline electronic data interchange.
National Standard Format
NSF, The name of the standardization of data to reduce paper and have more accurate information and efficient organization
A combination of letters and numbers that each individual is assigned to access computer data
real time
Online interactive communication between two computer systems allowing instant transfer of information.
standard transactions
The electronic files in which medical data are compiled to produce a specific format.
A T-carrier channel that can transmit voice or data channels quickly
taxonomy code
Numeric and alpha provider specialty codes that are assigned and classify each health care provider when transmitting electronic insurance claims
trading partner agreement
See Business associate agreement