MOP CHAPTER 8,9,10 – 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 LOOKS LIKE GIBBERSH TO UNAUTHORIZED USERS
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TRUE
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EVEN IF A PHYSICIAN'S OFFICE DOES NOT BILL MEDICARE AND DOES NOT SUBMITT TRANSACTIONS ELECTRONICALLY,DIRECTLY OR THROUGH A THIRD PARTY THE PRATICE IS STILL SUBJECT TO HIPPA TRANSACTION RULES
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TRUE
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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 STORED 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 SYSTEMS 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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CLEARINGHOUSES ALWAYS CHARGE A FLAT FEE FOR CLAIM PROCESSING.
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FALSE
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A GROUP OF INSURANDE CLAIMS SENT AT THE SAME TIME FROM ONE FACILITY IS KNOWN AS A
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BATCH
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A CLEARINGHOUSE IS A
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private or public entity that processes or facilitates the processing of electronic transactions.
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INSURANCE CLAIMS 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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ACCOUNT RECIEVABLE
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THE EMPLOYERS ID NUMBER IS ASSIGNED BY
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THE INTERNAL REVENUE SERVICE
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A CLEARINGHOUSE
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TRANSMITS CLAIMS TO THE INSURANCE PAYER PERFORMS SOFTWARE EDITS SEPERATES CLAIMS BY CARRIER
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INSURANCE CLAIMS FORM DATA ARE GATHERED
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BEFORE THE SERVICE IS RENDERED DURING THE TIME THE SERVICE IS RENDERED AND AFTER THE SERVICE IS RENEDERED
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BACK-UP COPIES OF OFFICE RECORDS SHOULD BE STORED
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AWAY 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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A FRONT END AUDIT
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BACK AND FORTH COMMUNICATION BETWEEN USER AND COMPUTER THAT OCCURS DURING ONLINE REAL TIME IS CALLED
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INTERACTIVE TRANSACTION
