NHA administrative assisiting Flashcards

1
Q

type of scheduling that allows 3 people to be booked at the same time and be attended in order of arrival
- 1 patient being late does not interrupt providers schedule

A

wave scheduling

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2
Q

type of scheduling where 2 patients are schedules at the same time to see the same provider

A

double-booking

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3
Q

this notice describes how a patients medical info may be used or disclosed+ how to access

A

notice of privacy practices

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4
Q

this system allows patients to cancel, confirm, or reschedule an appointment

A

automated call routing

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5
Q

SOAP method to document on progress sheet

A

S- subjective (chief complaint-what patient says)
O-objective(clinical indication-vital signs)
A- assessment/ medical diagnosis
P-plan for treatment

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6
Q

electronic medical record system function that allows providers to digitally order lab and radiology testign, treatments, referrals, and prescriptions

A

computerized physician order entry (CPOE)

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7
Q

what are some parts of a patients demographic info

A
  • full name
  • dob
  • address
  • insurance
  • marital status
  • job
  • social security
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8
Q

provided to the patient by the insurance company as a statement detailing what services were paid, denied, or reduced in payment

A

explanation of benefits (EOB)

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9
Q

explanation of benefits sent to the provider from the insurance company

A

remittance advice (RA)

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10
Q

a form a Medicare patient will sign when they think Medicare might not pay for a specific service or item

A

advance beneficiary notice (ABN)

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11
Q

allows specific reporting of diseases and newly recognized conditions, symptoms, injuries, etc
- 3 to 7 letters used

A

ICD- 10- CM
-International Classification of Diseases

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12
Q

system comprised of medical classifications for procedural codes used in inpatient settings (w/in hospitals) that record various treatments and testing

A

ICD-10-PCS
- procedure coding system (PCS)
INPATIENT

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13
Q

used to document procedures and technical services based on services by providers in outpatient settings
- OUTPATIENT

A

CPT codes
- current procedural terminology

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14
Q

group of codes and descriptions represent procedures, supplies, products, and services not listed in CPT code

A

HCPCS
- healthcare common procedure coding system

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15
Q

used to request payment from health insurance payers, like Medicare, after a patient has been treated
- claim is sent to the insurance company for reimbursement of services

A

CMS 1500

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16
Q

referrals should only be submitted after the approval of ____ and authorization of the _________- has been obtained

A

the provider
insurance company

17
Q

provider obtains permission to perform certain services or refers patient to specialist

A

preauthorization

18
Q

A decision by your health insurer or plan that a procedure when you are hospitalized is medically necessary.

A

precertification

19
Q

amount owed to the provider for services rendered

A

accounts receiveable

20
Q

if a check is returned to the medical office for nonsufficient funds, what is done

A

medical office has the right to charge additional fees to the patients account

21
Q

includes EMR and other info to be used between facilities

A

EHR

22
Q

method of filing where a new report is laid on top of an older report

A

shingling

23
Q

process of moving active files to an inactive status

A

purging

24
Q

describes the unlawful act of billing services at a higher rate than contracted to receive a larger reimbursement from a third-party payer

A

upcoding

25
Q

provides info regarding chemicals used in a medical facility

A

SDS- safety data sheets

26
Q

when MA receives instruction from doctor to refer a patient to a derm, what action do you take first

A

complete a patient referral form

27
Q

when a duplicate payment is given for services, what happens

A

credit balance is added to patients account

28
Q

the difference between what your physician billed your insurance company and what the insurance company has paid. _____________ are not billed to the patient; instead, they are written off by the health care provider

A

insurance disallowance

29
Q

a complete listing of fees used by Medicare to pay doctors or other providers/suppliers

A

fee schedule

30
Q

collab of physicians and health care staff whose goal is to reestablish the cost and quality of health care
- patients are not directly involved in this process

A

ACO
accountable care org

31
Q

provide patients with in-home services by health professionals to minimize effects of disabilities or diseases and to restore patients overall health

A

home health agency

32
Q

maximum reimbursement a third party will provide for a particular procedure or service

A

allowable amount

33
Q

policy where insurance and policyholder share the cost of covered services in a specific ratio, like 80:20

A

coinsurance

34
Q

list of charges for procedures and services performed at the providers office

A

fee schedule