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ch 8 sg IHMO

t or f, the exchange of data in a standardized format through computer systems is known as electronic data interchange.
T
the newest version of electronic claims submission is known as 6020 and was required effective February 1 2012
F
the national provider identifier identifies each individual health plan and is required on all claims as of may 23 2007
F
clearinghouses always charge a flat fee for claim processing
F
confidential data should be stored only in the computer’s hard drive
F
to ensure that data have been effectively backed up on the practice management system, verification of original records to stored information should be performed
Weekly
how often should the following procedure be done: post payments in practice management system:?
Daily
how often should the following procedure be done: note any problematic claims and resolve outstanding files:?
Weekly
How often should the following procedure be done: batch scrub edit and transmit claims:
daily or weekly
how often should the following procedure be done: review all claims rejection reports:
End of month
how often should the following procedure be done ; audit claims batched and transmitted with confirmation reports:
Daily
how often should the following procedure be done: make follow up calls to resolve reasons for rejections
weekly
how often should the following procedure be done: review clearinghouse/payer transmission reports
daily
how often should the following procedure be done: correct rejections and resubmit claims:
daily
how often should the following procedure be done; update practice management system with payer information
end of month
how often should the following procedure be done: research unpaid claims
weekly
the implementation of standard formats, procedures and data content into the electronic data interchange process is the result of HIPAA regulations
HIPAA

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