Exchange of data in a standardized format through computer connections is known as electronic data interchange.
Encrypted data often look like gibberish to unautherized users.
Submitting a claim to Medicare, the name of the insured is required, not situational.
Medicare claim must include standard code sets, such as CPT and ICD-9 codes.
Confidential data should be stored only in the computer’s hard drive.
An installed firewall and antivirus software help maintain computer security.
Practice management systems can be “rented” from practice management systems over the internet.
For insurance claims to be submitted electronically, a sign by the physician with the carriers involved is necessary.
Group of insurance claims sent at the same time from one facility is known as a?
A clearing house is a/an?
…An entity that receives the electronic transmission of claims from the health care provider’s office and translates it into a standard format prescibed in HIPPA regulations
Insurance claims transmitted elctronically are usually paid in?
…Two weeks or less
The most important function of a practice management system is?
The employer’s identification number is assigned by?
…IRS “Internal Revenue Service’
A clearing house?
…* Separate claims by carrier
* Perform software edits on each claim to check errors
* Transmit claims electronically to the correct insurance payer
Insurance claims form data are gathered?
…* Before Service Rendered
* During Service Rendered
* After Service Rendered
Back-up copies of office records should be stored?
…Off site Away from the office in case of fire, flood, or theft
When a medical practice has its own computer and transmits claims electronically directly to the insurance carrier, this system is known as?
A computer printout that used to look for errors before an insurance claim is transmitted electronically is called?
…insurance billing worksheet
Back and forth communication between user and computer that occurs during online real time is called?
Assigning a code to represent data is known as?
Combination of letters, numbers, or symbols that each individual is assigned to access computer the system is called a/an?
When keying data, it is wise to______frequently to save information.
An online transaction concerning the status of an INS. claim is called?
…ERA—– Electronic Remittance Advice
Employee’s who have access to patient’s medical records must have a high degree of_____and______.
…Responsibility and Accountability
A status report of claims is usually received?
For assignment of benefits, each patient’s______must be obtained.
A screen prompt is a _______?
An internal audit that reviews who has access to PHI. is a/an_________safeguard or security measure.
Automatic logoff that prevents unauthorized users from accessing a computer is a/an_______safeguard.How the physician handles the retention, removal, and disposal of paper records is a/an________safeguard.
Post payment in practice management system.
Note any problematic claims and resolve outstanding files.
Batch, scrub, edit and transmit claims.
…Daily and Weekly
review all claims rejection report.
…End of Month
Audit claims batched and transmitted with conformation reports.
Make follow up calls to resolve reasons for rejections.
Review clearinghouse/payer transmission reports.
Correct rejections and resubmit claims.
update practice management system with payer information.
…End of Month
Research unpaid claims.
Bone Marrow Transplantation
Breast Self Examination
cubic centimeter (same as ml: 1/1000 of liter
Abnormal Uterine Bleeding
Bilateral Salpingo Oophoectomy
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