Computers in the Medical Office CIMO chapters 1-5

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  1. Health Information Technology (HIT)
    technology that is used to record, store, and manage patient healthcare information
  2. Practice Management Programs (PMP)
    software programs that automate many of the administrative and financial tasks in a medical practice
  3. Functions of PMP programs
    verify ins, organize pt and payer info, generate and transmit claims, monitor status of claims, record payments from pt and payer, generate statements - post payments - update accts, managing collections activities, create financial and productivity reports
  4. Electronic Health Record (EHR)
    a computerized life-long healthcare record for an individual that incorporates data from all providers who treat the individual
  5. Documentation
    a record of healthcare encounters between the provider and the patient
  6. Electronic Medical Records (EMR)
    the computerized records of one physician's encounters with a patient over time.
  7. Personal Health Records (PHR)
    private, secure electronic files that arer created, maintained, and owned by the patient.
  8. Electronic Prescribing
    the use of computers and handheld devices to transmit prescriptions in digital format
  9. Three Advantages of EHR
    Safety, Quality, Efficiency
  10. Medical Documentation and Billing Cycle
    a ten-step process that results in timely payment for medical services.
  11. Patient Information Form
    a form that includes a patient's personal, employment and insurance data needed to complete an insurance claim.
  12. Diagnosis
    physician's opinion of the nature of the patient's illness or injury
  13. Procedure
    medical treatment provided by a physician or other healthcare provider
  14. Coding
    the process of translating a description of a diagnosis or procedure into a standardized code.
  15. Diagnosis Code
    a standardized value that represents a patient's illness, signs, and symptoms
  16. ICD-9-CM
    abbreviated title of International Classification of Diseases, Ninth Revision, Clinical Modification, the source of codes used for reporting diagnoses until October 1, 2015
  17. ICD-10-CM
    abbreviated tital of International Classification of Diseases, Tenth Reviwion, Clinical Modification, which will be used beginning on October 1, 2015
  18. Procedure Code
    a code that identifies a medical service
  19. Curent Procedural Terminoloy (CPT)
    the standardized classification system for reporting medical procedures and services
  20. HCPCS
    codes used for supplies, equipment, and services not included in the CPT codes
  21. Encounter Form
    a list of the procedures and diagnoses for a patient's visit
  22. Clearing House
    a company that receives claims from a provider, prepares them for processing, and transmits them to the payers in the required format
  23. Adjudication
    the series of steps that determine whether a claim should be paid
  24. Remittance Advice (RA)
    a document that lists the amount that hsas been paid on each claim as well as the reasons for nonpayment or partial payment
  25. Explanation of Benefits (EOB)
    paper document from a payer that shows how the amount of a benefit was determined
  26. Revenue Cycle Management (RCM)
    managing the activities associated with a patient encounter to ensure that the provider receives full payment for services
  27. Health Insurance Portability and Accountability Act (HIPAA)
    federal act that set forth guidlines for standardizing the electronic data interchange of administrative and financial transaactions, exposing fraud and abuse in government programs, and protecting the security and privacy of health information
  28. Electronic Data Interchange (EDI)
    the exchange of routine business transactions from one computer to another using publicly available communications protocols
  29. National Provider Identifier (NPI)
    a standard identifier for healthcare providers consisting of ten numbers
  30. HIPAA Privacy Rule
    regulations for protecting individually identifiable information about a patient's health and payment for healthcare that is created or received by a healthcare provider
  31. Protected Health Information (PHI)
    information about a patient's health or payment for healthcare that can be used to identify the person
  32. HIPAA Security Rule
    regulations outlining the minimum administrative, technical, and physical safeguards required to prevent unauthorized access to protected information
  33. Audit Trail
    a report that traces who has accessed electronic information, when information was accessed, and whether any information was changed
  34. Health Information Technology for Economic and Clinical Health Act (HITECH)
    part of the American Recovery and Reinvestment Act of 2009 that provides financial incentives to physicians and hospitals to adopt EHRs adn strengthens HIPAA privacy and security regulations
  35. Meaningful Use
    the utilization of certified EHR technology to improve quality, efficiency, and patient safety in the healthcare system
  36. Regional Extension Centers (REC)
    centers that offer information, guidance, training, and support services to providers transitioning to an EHR system
  37. Health Information Exchange (HIE)
    a network that enables the sharing of health-related information among provider organizations according to nationally recognized standards
  38. National Health Information Network (NHIN)
    a comon platform for health information exchange across the country
  39. Affordable Care Act (ACA)
    federal legislation passed in 2100 that includes a number of provisions designed to increas access to healthcare, improve the quality of healthcare, and explore new models of delivering an dpaying for healthcare
  40. Accountable Care Organizations (ACO)
    a network of doctors and hospitals that shares responsibility for managing the quality and cost of care provided to a group of patients
  41. Patient-Centered Medical Home (PCHM)
    a model of primary care that provides comprehensive and timely care to patients, while emphasizing teamwork adn patient involvement
  42. Database
    a collection of related bits of information
  43. Medisoft Program Date
    date the program uses to record when a transaction occurred
  44. MMDDCCYY format
    the way dates must be keyed in Medisoft. MM - month, DD - day, CC - century, YY - year
  45. Backup Data
    a copy of data files made at a specific point in time that can be used to restore data
  46. Restoring Data
    the process of retrieving data from backup storage devices
  47. Rebuilding Indexes
    a process that checks and verifies data and corrects any internal problems with the data
  48. Packing Data
    the deletion of vacant slots from the database
  49. Purging Data
    the process of deleting files of patients sho are no longer seen by a provider in a practice
  50. Recalculating Balances
    the process of updating balances to reflect the most recent changes made to the data
  51. Access Rights
    security option that determinesthe areas of the program a user can access and whether the user has rights to enter or edit data
  52. Auto Log Off
    feature of Medisoft that automatically logs a user out of the program after a period of inactivity
  53. Provider Selection Box
    a selection box that determines which provider's schedule is displayed in the provider's daily schedule
  54. Provider's Daily Schedule
    a listing of time slots for a particular day for a specific provider that corresponds to the date selected in the calendar
  55. Office Hours Calendar
    an interactive calendar that is used to select or change dates in Office Hours
  56. Office Hours Patient Information
    the area of the Office Hours window that displays information about the patient who is selected in the provider's daily schedule
  57. Chart Number
    a unique number that identifies a patient
  58. Recall List
    a list of patients who need to be contacted for future appointments
  59. Office Hours Break
    a block of time when a physician is unavailable for appointments with patients
  60. New Patient
    a patient who has not received services from the same provider or a provider of the same specialty or subspecialty within the same practice for a period of three years
  61. Established Patient
    a patient who has been seen by a provider in the same specialty or subspecialty within three years
  62. Guarantor
    an individual who may not be a patient of the practice but who is financially responsible for a patient account
  63. Case
    a grouping of transactions that share a common element
  64. Progress Note
    a physician's notes abouta patient's condition and diagnosis
  65. Referring Provider
    a physician who recommends that a patient see a specific other physician
  66. Primary Insurance Carrier
    the first carrier to whom claims are submitted
  67. Capitated Plan
    an insurance plan in which prepayments made to a physician cover the physician's services to a plan member for a specified period of time.
  68. Crossover Claims
    claims that are processed by Medicare and then transferred to Medicaid, or to a payer that provides supplemental insurance benefits to Medicare beneficiaries.
  69. Sponsor
    in Tricare, the active-duty service member
  70. Charges
    amounts a provider bills for the services performed
  71. Payments
    monies received from patients and insurance carriers
  72. Adjustments
    changes to patients' accounts that alter the amounts charged or paid
  73. MultiLink Codes
    groups of procedure code entries that relate to a single activity
  74. Walkout Receipt
    a receipt givin to the patient after a payment is made that lists the procedures, diagnosis, charges, and payment
  75. NSF Check
    a check that is not honored by a bank because the account it was written on does not have sufficient funds to cover it.
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Computers in the Medical Office CIMO chapters 1-5
2015-07-14 23:34:27

chapters 1-5
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