Office Financial Management, Billing & Insurance Flashcards
Bookkeeping
Record of financial transactions.
What are the 5 types of transactions?
1) Asset - resources
2) Liability - debts
3) Income - revenue
4) Expense - purchases
5) Equity - earnings
Double-entry Bookkeeping
Every transaction effects 2 accounts by increasing one & decreasing the other.
Fee Schedule
A complete listing of fees that are used to pay doctors or other providers/suppliers
Resources-based Relative Value Scale
RSBRVS
A payment system that is used to calculate medical payments for physician services by the CMS.
Diagnosis-Related Groups
DRGs
CMS pays for inpatient care based on principle diagnosis, age, and other complicating issues.
Contracted Fees
A benefit plan that prohibits extra billing.
What does CMS stand for?
Centers for Medicare & Medicaid Services
ICD-10-CM stand for
International Classification of Diseases, 10th Revisions, Clinical Modification.
HCPCS stand for
Health Common Procedure Coding System
CPT stand for
Current Procedural Terminology
Purpose of HCPCS
Used to fill claims for equipment, supplies and services that are not covered by CPT codes.
What is CPT?
A primary code system used to describe the treatment services provided for that diagnosis.
HCPCS Level 1
Identical to CPT codes, b/t when used bill Medicare/Medicaid it will used HCPCS codes.
HCPCS Level 2
Designed to represent non-physician services & supplies (e.g., ambulance) that aren’t covered by HCPCS Level 1.