Chapter 3: Patient registration and data capture

Question 1

What is PMS?

Answer 1

Practice Management System = EMR

Question 2

What are the 4 patient types?

Answer 2

1. Self pay
2. Medicare
3. Medicaid (coverage determined month to month)
4. Commercial carrier/private insurance
   
   • HMO, PPO, EPO, POS, IDS (Integrated Delivery System

Question 3

What is the Birthday Rule?

Answer 3

When a child is covered by two or more insurance plans, the health plan of the member covering the dependent whose birthday comes first in the calendar year is primary.
If both parents have the same birthday, the oldest policy is primary

Question 4

If a patient has regular insurance and cobra insurance, which is primary?

Answer 4

The regular coverage is primary

Question 5

A Childs parents are divorce. Who’s insurance is primary?

Answer 5

1. Custodial parents insurance is primary as long as they have not remarried
2. if they have remarried, custodial parent is primary and step parent is secondary. non custodial parent insurance is last resort.

Question 6

How often should an authorization form be updated?

Answer 6

Under HIPPA, they should be updated once a year or a covered entity cannot use or disclose PHI

Question 7

What is COBRA?

Answer 7

it was created under the Consolidated Omnibus Budget Reconciliation Act allowing an employee who leave a company to continue to be covered under the companies health plan for a certain time period