ch 8 sg IHMO – Flashcards
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t or f, the exchange of data in a standardized format through computer systems is known as electronic data interchange.
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T
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the newest version of electronic claims submission is known as 6020 and was required effective February 1 2012
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F
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the national provider identifier identifies each individual health plan and is required on all claims as of may 23 2007
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F
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clearinghouses always charge a flat fee for claim processing
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F
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confidential data should be stored only in the computer's hard drive
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F
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to ensure that data have been effectively backed up on the practice management system, verification of original records to stored information should be performed
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Weekly
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how often should the following procedure be done: post payments in practice management system:?
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Daily
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how often should the following procedure be done: note any problematic claims and resolve outstanding files:?
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Weekly
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How often should the following procedure be done: batch scrub edit and transmit claims:
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daily or weekly
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how often should the following procedure be done: review all claims rejection reports:
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End of month
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how often should the following procedure be done ; audit claims batched and transmitted with confirmation reports:
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Daily
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how often should the following procedure be done: make follow up calls to resolve reasons for rejections
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weekly
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how often should the following procedure be done: review clearinghouse/payer transmission reports
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daily
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how often should the following procedure be done: correct rejections and resubmit claims:
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daily
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how often should the following procedure be done; update practice management system with payer information
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end of month
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how often should the following procedure be done: research unpaid claims
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weekly
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the implementation of standard formats, procedures and data content into the electronic data interchange process is the result of HIPAA regulations
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HIPAA
