Insurance True/false Flashcards

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The exchange of data in a standardized format through computer connections is known as electronic data interchange.
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false
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Encrypted data often look like gibberish to unauthorized users
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true
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Even if aphysician's office does not bill Medicare and does not submit transctions electronically directly or through a third party the practice is still subject to HIPAA transaction rules
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False
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when submitting a claim to Medicare the name of the insured is required not situational
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FALSE
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A Medicare claim must include standard code sets such as CPT and ICD_9-CM codes
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True
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confidential data should be store only in the computer's hard drive.
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FALSE
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An installed firewall and antivirus software help maintain computer security
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True
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Practice management sysems can be rented from practice management systems over the internet
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TRUE
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For insurance claims to be submitted electronically a signed agreement by the physician with the carriers involved is necessary
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TRUE
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clearinghouse always charge a flat fee for claim processing
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TRUE
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A group of insurance claims sent at the same time from time from on facility is know as a
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batch
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a clearinghouse is an
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entity that receives transmission of insurance claims separate the claims and sends one electronically to the correct insurance payer
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insurance claim transmitted electronically are usually paid in
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two weeks or less
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The most important function of a practice management system is
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acounts receivable
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The employer's identification number is assigned by
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the internal Revenue Serice
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a clearinghouse
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transmits claims to the insurance payer performs software edits separates claim by carrier all the above
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insurance claims form data are gathered
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a before the service is rendered during the time the sevice is rendered after the sevice is rendered al the above
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Back up copies of office records should be stored
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aways from the office
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when a medical practice has its own computer and transmits claims electronically directly to the insurance carrier this system is known as
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carrier direct
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A computer printout that is used to look for errors before an insurance claim is transmitted electronically is called
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an insurance billing worksheet
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back and forth communication between used and computer that occur during oneline real time is called
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interactive transaction
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encrypted passwod backup electronic remittance adivice (ERA)
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resonsiblily accountabitity electronal signature question administrative technical physician
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assigning a code to represent data is known as
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encrypted
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a combination of letter numbers or symbols that each individual is assighned to access the computer system is called a/an
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password
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when keying data it is wise to ------x----- frequently to save information
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backup
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an online transaction concering the status of an insurance claim is called a/an
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electionic remittance adivice (ERA)
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employees who have access to patients medical records must have a high degree of
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responsiblily and acountabitily
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a status report of claims is recived
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electronal
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for assignment of benefits each patients
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signature
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a screen promt is a
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question
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an internal audit that review who has access to PHI is /an
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administrative safeguard or securirty mesasure
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an automatic lofoff that prevents unauthorized users from accessing a computer ia a/an
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technical safeguard
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how the physician office handles the retention removal and disposal of paper records is a /an
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physician safeguard
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Post payments is practice mangement system
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daily
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note any problematic claim and resolve outstandind files
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weekly
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Batch scub edit and transmit claims
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weekly
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review all claim rejection reports
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end month
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audit claims batched and transmitted withh confirmation reports
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daily
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make follow up calls to resolve reasons for rejections
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weekly
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review clearing house payer transmission reports
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daliy
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correct rejections and resubmit claim
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daliy
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update practice managent system with payer information
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end of the month
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weeking
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research upaid claims
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