Module 15: Administrative Assisting Flashcards
Appointment Book
book used schedule, cancel, reschedule appointments
color coded or arranged
Matrix
table used for scheduling
Template
outline used to make new pages with similar design, pattern, style
Wave Scheduling
scheduling three patients at the same time to be seen in order in which they arrive
Modified Wave Scheduling
allocating two patients to arrive at specfied time/third to arrive 30 mins laer, repeated throughout the day
Double-Booking
scheduling two patients at same time with the same provider, often to fit in patient has acute illness
Filing Systems/Processes
conditioning-grouping related papers together, removing all paper clips/staples, attaching smaller papers to regular, fix damange records
releasing-marking form to filed with mark (ready filed, provider’s inital, stamp)
indexing/coding-determined where to place
sorting-ordering papers in specific groups
Filing Types
alphabetic-arranged last, first, middle
numeric-larger health centers or hosptals
subject-specific tab
How to Schedule Internal Appt. with Established Patient
name, DOB, reason
determined amount of time needed
what day and time
consider availability, provider preferences, patient habits
How to Schedule External Appt. with New Patient
name, address, DOB, contact, insurance info, social security, emergency contact, give them registration packet/medical history
Five Basic Steps of Filing Paper Records
conditioning, releasing, indexing, coding sorting, storing
SOAP Method of Documenting Info
subjective impressions
objective findings or clinical indication
assessment or medical diagnosis
plan for treatment
CHEDDAR Method of Documenting Info
chief complaint
history
examination
details
drugs and dosages
assessment
return visit information
Info to Verify Patient Health Insurance
full name
DOB
policy number
SS Number
Chart Reviews
checking over charts to reduce payment errors by making sure payment is only made for services that meet medical necessity requirements/ are covered by insurance plan
3 Factors Determine Level of Service E/M Coding
History
Exam
Medical Decision Making
3 Types of Referrals
Regular- 3 to 10 business days
Urgent- 24 hours
Stat- approved by phone immediately
Difference Between Preauthorizations/Precertifications
Preauthorization obtaining permission to perform specific procedures/services or refer a patient to a specialist
Precertification proving medical necessity before performing procedure
Copay
specific sum of money based on patient’s insurance policy benefits due at the time of service
Coinsurance
amount a policyholder is financially responsible for according their insurance policies
80/20
80% paid to insurance and 20% to you
Deductibles
specific amount of money patient must pay out of pocket before the insurance company
Explanation of Benefits
EOB
provided to patient by insurance company as statement detailing service were paid, denied, reduced NOT A BILL
Remittance Advice
RA
explanation of benefits sent to provider from insurance carrier post payment
Advance Beneficiary Notice
ABN
form a medicare patient when a provier thinks medicare won’t pay for it
Federal Policies
include Tricare, military, 65 or up, anything with state
Private Policies
group, fund themseleves
ICD-10-CM
7 characters
1st alaphabetic, 2-3 numeric, 4-7 either
diagnosis
ICD-10-PCS
hospital
procedures normally in hospital
CPT
procedures
procedures/services based by provider in outpatient setting
HCPCS
procedures everything CPT does not cover
Electronic Medical Record
EMR
info about a patient that can be created, managed, accessed by authorized people within a single place
Electronic Medical Record
EMR
information on patient that can be given to whoever needs it
Supplies
pen, pencil, paper, toner, paper clips, registration form, info sheets, clipboards
OSHA
responsible for workers
