Medicare Flashcards
CPT CODE
Current Procedural Terminology
a uniform language for coding medical services and procedures to streamline reporting, increase accuracy and efficiency
HCPCS
Health Care Procedure Coding System:
HCPCS is a collection of standardized codes that represent medical procedures, supplies, products and services. The codes are used to facilitate the processing of health insurance claims by Medicare and other insurers. HCPCS is divided into two subsystems, Level I and Level II.
HIPPA
Health Insurance Portability and Policy standards Act
The U.S. Department of Health and Human Services (HHS) developed a set of federal standards for protecting the privacy of personal health information
HITECH
Health Information Technology for Economic and Clinical Health
was signed into law on February 17, 2009, to promote the adoption and meaningful use of health information technology.
MEDICAID
government-sponsored insurance program for individuals and families whose income is insufficient to cover health related services. varies from state to state
Medicare
federal health insurance for people 65 or older, some younger people with disabilities, people with End-Stage Renal Disease - ESRD
MIPS
Merit-Based Incentive Payment System (MIPS) (for Medicare)
latest step in the Centers for Medicaid & Medicare transformation to pay-for-value. often do not account for uncaptured clinical status and social determinants of health in patients at high social risk, and the consequences for clinicians and patients associated with their use. The MIPS scores can range from 0 to 100. A score of less than 3 can lead to negative payment adjustment; a score of greater than 3 but less than 70 to a positive adjustment; and a score of 70 or higher to the exceptional performance bonus.
Health Outcomes
Viewing data as a larger data set to understand how changes in populations’ health and medical interventions, can change:
Bridge Roles
Health Information Management Professionals often serve in these roles
What happens as health information technology advances
The role of the HIM professional expands.
What is an Application Program Interface system
A system that can send or retrieve data to update an individual’s record
Informatics
An integrated discipline with specialty domains includes management science, management engineering principles, healthcare delivery and public health, patient safety, information science and computer technology.
What framework is used to manage health information
Health Information Technology
Population Health
Proactively identifying, analyzing, and making improvements to medical care, environments, and social factors relevant to the health of a larger group of people
What combines business, science and information technology?
Health Information Management
