Ch. 7: Insurance Claims

Question 1

EMR

Answer 1

Electronic Medical Record

• Replaces paper medical records that people used to update by hand
• One EMR for each individual at each healthcare facility
• Used within one healthcare facility or organization

Question 2

EHR

Answer 2

Electronic Health Record

• Created, managed, and accessed across more than one healthcare organization
• Allow interoperability, which means that systems can share information
• One EHR for one patient across multiple locations

Question 3

how long of an absence is required to be considered a new patient again?

Answer 3

3 years

Question 4

ECS

Answer 4

electronic claims submission

Question 5

NPI

Answer 5

National Provider Identifier (NPI): 10-digit numeric identifier that complies with HIPAA standards

Question 6

NUCC

Answer 6

National Uniform Claim Committee (NUCC)

• Voluntary organization formed to develop a standardized data set for professional (non-institutional) claims
• Committee members represent providers, payers, and standards maintenance organizations
• Also standardizes data elements for electronic claims