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Test review 116-4

Exchange of data in a standardized format through computer connections is known as electronic data interchange.
…True
Encrypted data often look like gibberish to unautherized users.
…True
Submitting a claim to Medicare, the name of the insured is required, not situational.
…True
Medicare claim must include standard code sets, such as CPT and ICD-9 codes.
…True
Confidential data should be stored only in the computer’s hard drive.
…False
An installed firewall and antivirus software help maintain computer security.
True
Practice management systems can be “rented” from practice management systems over the internet.
…True
For insurance claims to be submitted electronically, a sign by the physician with the carriers involved is necessary.
…True
Group of insurance claims sent at the same time from one facility is known as a?
…batch
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?
…Accounts Recievable
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?
…carrier-direct
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?
…Interactive transaction
Assigning a code to represent data is known as?
…Encryption
Combination of letters, numbers, or symbols that each individual is assigned to access computer the system is called a/an?
…Password
When keying data, it is wise to______frequently to save information.
…Back-up
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?
…Electronically
For assignment of benefits, each patient’s______must be obtained.
…Authorized Signature
A screen prompt is a _______?
…Question
An internal audit that reviews who has access to PHI. is a/an_________safeguard or security measure.
…Administrative
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.
…Technical and
Physical safeguard
Post payment in practice management system.
…Daily
Note any problematic claims and resolve outstanding files.
…Weekly
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.
…Daily
Make follow up calls to resolve reasons for rejections.
…Weekly
Review clearinghouse/payer transmission reports.
…Daily
Correct rejections and resubmit claims.
…Daily
update practice management system with payer information.
…End of Month
Research unpaid claims.
…Weekly
@
at
BMT
Bone Marrow Transplantation
BSE
Breast Self Examination
cc
cubic centimeter (same as ml: 1/1000 of liter
AP
Anterior Posterior
AUB
Abnormal Uterine Bleeding
C
Carbon ; Calorie
c/o
complaint of
CC
Chief Complaint
BSO
Bilateral Salpingo Oophoectomy

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