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EHR Chapter Review – CH 3 & 4

pre-existing condition
illness or disorder of a beneficiary that existed before the effective date of insurance coverage
indemnity plan
a type of medical insurance that reimburses a policyholder for medical services under the terms of its schedule of benefits
an amount that an insured person must pay, usually on an annual basis, for health care services before a health plan’s payment begins
the portion of charges that an insured person must pay for health care services after payment of the deductible amount
a health plan or program
the amount of money a health plan pays for services covered in an insurance policy
a transfer of patient care from one physician to another
money the insured pays to a health plan for a health care policy, ususally paid monthly
medical insurance
a financial plan that covers the cost of hospital and medical care
T or F – preferred provider organizations are the most popular type of managed care plans
T or F – a consumer-driven health plan involves a high-deductible health plan coupled with a tax-preferred savings account
T or F – the third party to a medical insurance contract is the policyholder
T or F – health plans pay for covered and noncovered services
T of F – on an electronic schedule, each provider’s schedule must be viewed separately
T or F – many manged care plans also cover preventive medical services
T or F – a new patient is someone who has not received any services from the provider (or another provider of the same specialty who is a member of the same practice) within the past two years
T or F – it is best to wait to obtain the patient’s reason for the visit at the time of the encounter
T or F – a paper referral document is a specific set of instructions from the primary care physician that directs the patient to a specialist or facility for medically necessary care
T or F – the three categories of informatin new patients provide during telephone preregistration are patient demographics, basic insurance information, and the reason for the visit
the preauthorization number may also be called the _________ number.

eligibility, verification, certification, demographic

patient portals
websites that can be used by patients to make appointments or receive messages formt heir health care providers are known as ______.

patient portals, health care networks, electronic records, medical alerts

examples of different scheduling systems include open-hours scheduling, _________ scheduling, double-booking and wave scheduling.

rotating, ripple, stream, flow

the process of gathering informaton about a new patient before an appointment is known as ____.

prerecording, preregistration, preauthorization, predetermination

a participating provider
in most managed care insurance plans, patients must use network physicians to avoid paying higher charges. For this reason, patients check whether the provider is ___________ in their plan.

a practicing physician, a participating provider, an authorized provider, a preferred provider

at the time an HMO member sees a provider, he or she pays a specified charge called the ________.

copayment, coinsurance, premium, indemnity

schedule of benefits
the medical insurance policy for each health plan contains the __________ that summarizes the payments that may be for medically necessary services received by policyholders.

schedule of referrals, diagnostic code list, formaulary of benefits, schedule of benefits

managed care
although there are many variations in the way health plans are structured, indemnity and __________ plans are the basis of all of them.

workers’ comp, individual, managed care, group

right mouse button
to display a shortcut menu with cut and paste commands for cutting and pasting appointments in Office Hours, press the ____________.

enter key, delete key, left mouse button, right mouse button

referral and authorization
a certification number for a procedure is the result of the _________ transaction and process.

coordination of benefits, referral and authorization, claims status, eligibility for a health plan

premium, medical insurance, covered, benefits, copay
if you have paid your ________ and your _________ policy is up-to-date, the __________ services, listed on your schedule of _________, will be paid by your insurance. However, you will still be responsible for the ________ for each visit.

benefits, medical insurance, premium, copay, covered

medical insurance, policyholder, health plan, payer, premium, benefits,
__________ is a written policy between an individual, called the ________ and a _________, an insurance company or government program that is the ________. The policy holder pays a specified amount of money call a __________. In exchange, the policy holder receives ___________, defined by America’s Health Insurance Plans (AHIP) as payments for covered medical services for a specific period of time.

policyholder, health plan, payer, medical insurance, premium, benefits

a confidential authentication information
a process of retrieving data from a back up storage device
a folder that contains all records pertaining to a patient
a panel in MCPR that offers providers a convenient view of important information
Medisoft Clinical Patient Records
an electronic health record application within Medicsoft Clinical.
chief complaint
a patients description of the symptoms or reasons for seeking medical care
user name
a name that an individual uses for identification purposes when logging onto a computer or an application
a collection of related bits of information
knowledge base
a collection of up-to-date technical information
backing up
making a copy of data files at a specific point in time that can be used to restore data
T or F – access levels define which areas of the program a user can view, and whether the user can only view the information or can also add, edit, or delete it
T of F – the encounter steps include only activities that take place before the patient arrives for an office visit
T or F – disaster recovery plans require practices to back up computer data
T or F – a user must be online to access any of the help features for Medisoft Network Professional and Medisoft Clinical Patient Records
T or F – medisoft clinical is a practice management and electronic health record program for physician practices.
T or F – Medisoft Network Professional is the Medisoft application used for patient accounting
T or F – the pre-encounter steps include preregistration and appointment scheduling
T or F – Medisoft Clinical Patient Records is the personal health record component of Medisoft Clinical
T or F – the result of a claim review are sent to the provider along with the payment
numeric codes
once an examination is complete and the documentation has been entered in MCPR, the services provided and the provider’s determination of the patient’s diagnoses must be assigned ___________.

letters, numeric codes, names, all of the above

disaster recovery plan
a plan for resuming normal operations after a disaster such as a fire or a computer malfunction is a ________.

back up plan, restoring plan, disaster recovery plan, all of the above

all of the above
which of the following is a built-in security feature of Medisoft Clinical?

user names, passwords, access levels, all of the above

knowledge base
the website contains a searchable _______ which is a collection of up-to -date technical information about Medisoft products

database, dashboard, knowledge base, user name

both a and b
the pre-encounter steps include _________

appointment scheduling, preregistration, claim preparation, both a and b

the term _______ refers to a patient’s medical record.

chart, database, dashboard, consult

what is the process of copying backup files onto the office’s computer systems, facilitating a return to normal business activities?

restoring, backing up, parking, both a and b

to receive payment, a medical practice must create and submit _________ to health plans

diagnoses, claims, statements, adjudication

all of the above
a statement lists _______

all service performed, the amount paid by the health plan, the charges for each service performed, all of the above

office hours
Medisoft Network Professional includes _______ , a scheduling program

Medisoft Clinical Patient Records, auto log off, office hours, none of the above

a student who is familiar with Medisoft Clinical should be able to _______ many skills taught in this book to other similar programs

transfer, relearn, either a or b, neither a or b

medisoft network professional
MNP is the abbreviation for __________

Microsoft network plan, medisoft network professional, medisoft national plan, none of the above

medisoft network professional
what is the practice management application within medisoft clinical _________

medisoft database, medisoft network professional, medisoft clinical patient records, medisoft dashboard

medisoft clinical patient records
what is the electronic health record application within medisoft clinical _______________?

medisoft database, medisoft network professional, medisoft clinical patient records, medisoft dashboard

both a and b
medisoft clinical is a _____________ program for physician practices.

practice management, electronic health record, personal health record, both a and b

Medisoft clinical has security features to ensure compliance with the ________ privacy and security regulations


user name, password
in order to log in to medisoft clinical an individual must enter both a _______ and a _______

access number; password
user name; password
password; control number
control key; password

the use of user names and passwords prevents _________ access to the program, safeguards critical patient information, and protects patient confidentiality.

provider, health plan, unauthorized, unidentified

access levels
medisoft clinical can have a number of ___________ created for different positions in the office

control numbers, administrative functions, access levels, none of the above

access levels
if you are in charge of medisoft clinical security and you want to allow the physicians and nurses to enter and edit clinical data, while permitting the billing specialists and receptionists to only view that data, determine the security option that you would use.

user names, access levels, passwords, park feature

electronic databases
medisoft clinical patient records stores patient information in a number of ________

electronic databases, paper file folders, charts, none of the above

a ___________ is a collection of related pieces of information

dashboard, database, chart, knowledge base

the term _______ refers to a patient’s medical record

dashboard, database, chart, knowledge base

all of the above
physician practices use medisoft network professional to __________.

enter charges, follow up on accounts, create statements, all of the above

medisoft network professional includes office hours, a __________ program.

filing, charting, scheduling, accounting

chief complaint
the patient’s ________ is that patients’ description of the symptoms or reasons for seeking medical care

chief concern, main concern, chief complaint, all of the above

manually; electronically
tasks formerly completed ________ are now performed _________ through the use of computers.

by freelancers; by billing staff
using pencils; electronically
manually; electronically
none of the above

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