health info. management terms Flashcards
adjudication
process of reviewing, paying, or denying claims that have been submitted by a healthcare provider
brand name drug
a drug sold by a drug company under a specific name that has a patent
generic drug
medicine created to be a replica of a brand name drug with the same ingredients. They are available at lower costs.
diagnostic test
tests used to help diagnose diseases and conditions
home health care
health care services that can be given in patients homes
pre-existing conditions
illness/injury experiences before getting a new health insurance plan
UPIN
stands for Unique Physician Identification Number which is assigned to licensed physicians in the US that give care to Medicare patients
SCHIP
stands for State Children’s Health Insurance Program; this provides health care to low-income, uninsured kids through different programs like Medicaid
SSN
stands for Social Security Number; given to US citizens and residents, most healthcare providers will ask for patients SSN to verify identity and collect payments
RFI
stands for, Release of Information. This is important to the quality of continuing care to a patient, and in billing, reporting, and research
PHI
stands for, Protected Health Information, which is health information in any form, like physical, electronic, and spoken information
ICD-10-PCS
stands for, International Classification of Diseases 10th Revision Procedure Coding System. This is the official system for assigning codes to procedures with hospitalization and a classification system for procedural codes.
HIPPA
stands for, Health Insurance Portability and Accountability Act. This improves efficiency, and protects private patient health information to ensure its secure.
EOB
stands for, Explanation of Benefits. This is a statement from your health insurance plan to tell you what costs are covered or what was received.
EMR
stands for, electronic medical records. This is significant in healthcare because it digitizes medical charts that were written on paper
